Since 1965 we have performed 67 operations to correct a subclavian steal-syndrom. Mortality after transthoracic correction in 30 patients was 6.7%, but we lost no patient after 37 extrathoracic reconstructions. The long-term results in these reconstructive procedures were excellent with a patency of 94.7% from the forth through the fifth year after transthoracic approach. Over 90% of the patients were asymptomatic or improved.