[Surgical reconstruction for subclavian arterial obstruction at its origin]

The authors, having experienced 17 cases of subclavian arterial obstruction at its origin in Montpellier, France and in Japan, performed direct anastomosis between the divided end of the proximal subclavian artery and the ipsilateral common carotid artery (transposition technique) in 12 cases. Our series of 17 patients ranging in age from 30 to 73 years who were evaluated for variety of symptoms: 8 had subclavian steal syndrome; 12 had claudication of upper extremity; 1 had visual disturbance; 3 had vertigo; and 1 had ear throbbing. Twelve patients were treated surgically with division of the proximal subclavian artery and its anastomosis to the common carotid artery by means of supraclavicular cervicotomy. One was treated with carotid subclavian bypass grafting, and 4 were placed aorto-carotid-subclavian bypass grafting with median sternotomy because of the proximal occlusive lesions at the origins of common carotid and subclavian artery due to aortitis syndrome. All the patients were relieved from the symptoms which had been existed in pre-operative stage. The transposition technique is simple, effective and few complications.