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Surgical experience of a rare case of congenital subclavian steal syndrome is reported. A 53 year old man was admitted to our hospital complaining of black out attack and headache. Non invasive and angiographic studies revealed the subclavian steal associated with right aortic arch and atretic aberrant left subclavian artery. Through the supraclavicular incision, the direct anastomosis of the left common carotid and subclavian artery was performed. Postoperative angiograms showed a perfect reconstruction of the left subclavian artery and the disappearance of the subclavian steal and about on third amount of the complaints are still remained. Concerning a review of the literatures, several problems are discussed.
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