Bypass surgery for aortitis syndrome: aortocarotid bypass with saphenous vein graft

In seven patients with Takayasu arteritis, symptomatic cerebral ischemia was successfully treated by extracranial bypass surgery. We performed 14 surgical procedures, which included aortocarotid bypass, axilloaxillary bypass, carotid-vertebral bypass, subclavian-carotid bypass, axillocarotid bypass, carotid-carotid bypass, carotid-subclavian bypass, carotid-axillary bypass, and thyreocervical-carotid anastomosis. Among those the aortocarotid bypass was the most common procedure performed--six occasions in four cases. The others were less common procedures, each performed only one time. The saphenous vein was used for the graft in 12 of the procedures. An artificial graft made of Gore-Tex (6-mm inner diameter) was utilized in two cases. Patency of the grafts was adequate and no mortality or serious postoperative complication was encountered. Asymptomatic infarction developed in one patient. We analyze these procedures in detail and stress the usefulness of aortocarotid bypass with a saphenous vein graft.