Five cases are reported with the pathological entity of proximal arterial stenosis and embolization into the peripheral vascular bed. Therapeutic management, e.g. diagnostic work-up, eradication of the embolic source and embolectomy of the peripheral arterial tree - if technically feasible - seems beyond any doubt. Sometimes the diagnosis is difficult to obtain, since in the upper extremity microembolic seeds occur, posing a differential diagnosis problem. Once a partial sternotomy and in situ removal of the lesion was employed, in the remaining cases extrathoracic repair was done. In the left subclavian artery using a carotid-subclavian-anastomosis, we obtained satisfactory results, in the right subclavian and end-to-end-anastomosis was performed after resection of the diseased arterial segment.

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