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Fig. 6B. —83-year-old woman with known atherosclerotic disease of left subclavian artery. Doppler sonogram shows that when blood pressure cuff is inflated on left arm, then rapidly deflated, there is conversion of waveform in left vertebral artery from presteal pattern to complete steal pattern, in which there is total reversal of flow throughout cardiac cycle. Blood pressure cuff maneuver induces reactive hyperemia in arm and increases blood flow across subclavian stenosis. Higher velocities within subclavian artery result in complementary drop in pressure and redirection of blood flow in ipsilateral vertebral artery toward its now-lower-pressure subclavian origin.