Subclavian artery stenosis causes pain, coldness, and claudication in the upper limbs due to the narrowing at the base of the artery. In addition, the compensatory blood supply from the vertebrobasilar artery system can lead to cerebral ischemic symptoms such as fainting and dizziness. Herein, we report the case of an 86-year-old female patient who presented with unilateral progressive dry necrosis of the digits caused by subclavian artery stenosis. The patient did not exhibit cerebral ischemic symptoms. Contrast-enhanced computed tomography revealed stenosis at the bifurcation of the subclavian artery and vertebral artery, which impeded the development of a compensatory blood supply and consequently prevented cerebral ischemia. We performed percutaneous transluminal angioplasty followed by amputation, which yielded favorable results. Common causes of finger ulcers and necrosis include critical hand ischemia and hemodialysis-associated steal syndrome. Subclavian artery stenosis should be considered as a differential diagnosis.
