About Video

This video clip transesophageal echocardiographic (TEE) identification of left subclavian artery stenosis with steal phenomenon. (step i) Arrow demonstrates long stenotic segment of the left subclavian artery (LSA) shortly after its origin from the aorta; (step ii to iv). Arrowheads denote large atherosclerotic plaque as cause of stenosis; (step v) Color Doppler-guided continuous wave interrogation of the stenotic segment shows a high peak velocity of 3.5 m/s (equivalent to a gradient of 49 mm Hg), indicative of severe stenosis; (step vi) Normalization of flow velocity in LSA distal to the stenosis; (step vii and viii). Reversal of flow is noted in the left vertebral artery (VA), consistent with steal phenomenon. (LCC: Left common carotid artery; R: Artifactual reverberations).