Occlusive disease of the vessels of the aortic arch-diagnosis and management.

Physicians should be alert to the possibility of occlusion of one or more of the branches of the aortic arch in any patient having neurologic symptoms or complaint of claudication in the upper extremities. The finding of a pulse deficit in the neck or arm and a blood pressure difference of more than 30 mm of mercury between the two arms is pathognomic of this disease. The presence of the occlusive process can be confirmed and its extent determined by angiography.Vascular reconstruction can be expected to restore normal hemodynamics with gratifying relief of symptoms in the majority of cases.