Use of the axillary artery in complex cerebral revascularization

Two cases of complex common carotid and innominate artery disease managed by axillocarotid autogenous saphenous vein bypass are presented, including a detailed description of the operative technique. The results in each case were gratifying. Although the concept of extra-anatomic repair is not new, this modification in operative technique expands the surgeon's armamentarium. The ease and safety of exposure and anastomosis of the axillary artery combine to make it the preferable donor vessel for extra-anatomic cerebral revascularization in the poor-risk, elderly patient population.