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[Extra-anatomical bypass for subclavian artery occlusion]
Insights
Extra-anatomical bypass effectively treats subclavian artery occlusion, offering symptom relief and high graft patency. This safe and durable procedure is ideal for high-risk patients with this condition.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
Context:
- Subclavian artery occlusion presents significant challenges, often leading to upper extremity ischemia and vertebrobasilar insufficiency.
- Conditions like Takayasu's arteritis and atherosclerosis are primary causes of subclavian artery occlusion.
Purpose:
- To evaluate the safety, efficacy, and durability of extra-anatomical bypass for treating subclavian artery occlusive disease.
- To assess symptom relief, complication rates, and graft patency in patients undergoing this surgical technique.
Summary:
- A study of 20 patients (9 male, 11 female) aged 20-63 with subclavian artery occlusion treated via extra-anatomical bypass (carotid-subclavian/axillary or axilloaxillary).
- No operative deaths occurred; symptom relief was achieved in 19 of 20 patients, with one experiencing reocclusion.
- The procedure demonstrated few postoperative complications and a high patency rate, highlighting its effectiveness.
Impact:
- Extra-anatomical bypass is a safe, simple, well-tolerated, and durable option for managing subclavian artery occlusive disease, particularly in high-risk individuals.
- This surgical approach offers a viable solution for patients experiencing debilitating symptoms of upper extremity ischemia and vertebrobasilar insufficiency.
Abstract:
20 patients with subclavian artery occlusion were treated by extra-anatomical bypass from 1989 to 1996. There were 9 men and 11 women, aged from 20 to 63 years with a duration of 1 month to 18 years. The main causes of illness were Takayasu's arteritis and atherosclerosis. Symptoms of upper extremity ischemia were present in 17 patients and vertebrobasilar insufficiency in 11. Carotid-subclavian/axillary bypass and axilloaxillary bypass were performed on 17 and 3 patients respectively. There were no operative deaths. Relief of symptomes was achieved in all the patients except one who had reocclusion of bypass graft due to rather poor outflow vessel. We stressed the surgiacal technique of extra-anatomical bypass in the treatment of subclavian artery occlusion. With few postoperative complications and high patency rate, we consider extra-anatomical bypass a safe, simple, well-tolerated and durable procedure for the treatment of subclavian artery occlusive disease in high-risk patients.