65 year old male with asymmetric upper extremity blood pressure readings and left arm fatigue with activity.
Comment: Given the left subclavian artery occlusion at the origin with almost none of the occluded vessel evident on the thoracic aortogram, it was best to gain upper extremity arterial access to facilitate the attempt at crossing the occlusion. Once we were able to cross the occlusion, we didn't want to place the sheath needed for stent placement. Therefore, we used a snare to capture the guidewire and ultimately placed a balloon-expandable stent across the occlusion from a common femoral artery approach.