Late results after extra-anatomic bypass routes

Area of Science:

• Vascular Surgery
• Surgical Outcomes
• Reconstructive Procedures

Background:

• Subclavian artery lesions can lead to significant upper extremity ischemia.
• Various surgical bypass techniques exist for treating these conditions, each with distinct long-term patency rates.
• Optimal graft selection remains crucial for successful vascular reconstruction.

Purpose of the Study:

• To evaluate the long-term efficacy and outcomes of carotido-subclavian grafts.
• To compare the patency rates of femoro-femoral and axillo-femoral bypasses.
• To establish guidelines for the routine use of axillo-femoral bypass surgery.

Main Methods:

• Retrospective analysis of 37 carotido-subclavian grafts.
• Assessment of long-term patency for femoro-femoral bypasses (3-5 years).
• Evaluation of patency in 7 axillo-femoral grafts.

Main Results:

• Carotido-subclavian grafts achieved 100% patency through the third postoperative year with 0% operative mortality.
• Femoro-femoral bypasses demonstrated a long-term patency of 79.7% between the third and fifth years.
• Axillo-femoral grafts showed a 71.4% patency rate (5 out of 7 grafts).

Conclusions:

• Carotido-subclavian grafting is a highly effective and preferred method for subclavian lesion correction.
• Axillo-femoral bypass should be reserved for patients with infected aortoiliac segments, not as a routine procedure.