Clinical Presentation

A 67-year-old woman presents with weakness of the left arm, claudication of the jaw, and headaches.

(A) Digit al subtraction aortogram in the left anterior oblique view demonstrates a smooth decrease in caliber of the right subclavian artery (double arrow) and a severe smooth decrease in caliber of the left mid and distal portions of the subclavian artery (arrow). The thoracic aorta is normal. (B,C) Selective injections of the left (B) and right (C)