In this scenario, the suprasternal frontal view shows the left carotid as the first vessel coming off the arch, followed by the right carotid, the right subclavian and last the left subclavian.

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Right-side retrograde brachial arteriography delineated the left vertebral artery via the right vertebral artery, suggesting proximal obstruction of the left subclavian artery (Fig. 6).

Additionally, torsion of these arteries was a significant factor in our cohort. We suspect that, when combined with future fluid dynamics analysis, the vascular anatomy of the brachiocephalic or ...