Related Experiment Videos
Cerebral revascularization by axillary-carotid bypass
1Wake Medical Center, Raleigh, North Carolina.
The Journal of Cardiovascular Surgery
|March 1, 1989
Summary
Axillary-carotid bypass offers a technically simpler and durable alternative for carotid revascularization. This study shows all grafts remained open, supporting its use for severe carotid stenosis or occlusion.
Area of Science:
- Vascular Surgery
- Cerebrovascular Disease
Background:
- Revascularization for symptomatic proximal common carotid artery (CCA) stenosis or occlusion often necessitates bypass surgery.
- Subclavian-carotid bypass is a common surgical approach.
Purpose of the Study:
- To evaluate the safety and efficacy of axillary-carotid bypass as an alternative to subclavian-carotid bypass.
- To assess graft patency and clinical outcomes in patients undergoing axillary-carotid bypass.
Main Methods:
- Retrospective review of 13 patients undergoing axillary-carotid bypass over 5 years.
- Grafts were tunneled under the clavicle with distal anastomoses to the common, internal, or external carotid arteries.
- Graft patency assessed by Doppler ultrasound; cerebral hemodynamics evaluated using Gee oculoplethysmography.
Main Results:
- No perioperative deaths occurred.
- One stroke was observed in a patient with a Dacron graft to the CCA and concomitant carotid endarterectomy.
- All grafts were patent at a mean follow-up of 2.5 years.
- Improved cerebral hemodynamics confirmed in 11 patients.
Conclusions:
- Axillary-carotid bypass is a technically feasible and durable option for extracranial cerebral revascularization.
- This procedure provides a viable alternative when proximal CCA revascularization is required due to severe stenosis or occlusion.