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[Intersubclavian bypass. Technic. Indications. Remote results].

J M Cormier, F Koskas

    Journal De Chirurgie
    |February 1, 1987
    PubMed
    Summary
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    The inter-subclavian bypass operation is a valid treatment for proximal subclavian artery or brachiocephalic trunk occlusive lesions when other methods fail. This procedure demonstrated excellent long-term patency and satisfactory hemodynamic outcomes with minimal operative risk.

    Area of Science:

    • Vascular Surgery
    • Cardiovascular Medicine
    • Interventional Cardiology

    Background:

    • Occlusive lesions of the proximal subclavian artery and brachiocephalic trunk can lead to significant cerebrovascular and upper extremity ischemia.
    • Surgical intervention is often necessary when less invasive methods are not feasible or have failed.
    • The inter-subclavian bypass is a reconstructive technique considered for complex cases.

    Purpose of the Study:

    • To evaluate the efficacy and safety of the inter-subclavian bypass operation.
    • To assess the long-term patency rates and hemodynamic outcomes of this surgical approach.
    • To determine the applicability of this procedure in patients unsuitable for other treatments.

    Main Methods:

    • A retrospective review of 34 patients undergoing inter-subclavian bypass between 1974 and 1984.

    Related Experiment Videos

  • Focus on patients for whom alternative surgical or endovascular options were not viable.
  • Assessment of perioperative morbidity, mortality, graft patency, and hemodynamic results using Doppler ultrasound.
  • Main Results:

    • The inter-subclavian bypass demonstrated no operative mortality or morbidity directly related to the procedure itself.
    • One late death occurred due to myocardial infarction.
    • Excellent early and late graft patency was achieved, contingent upon the absence of significant lesions in the inflow arteries.
    • Doppler ultrasound confirmed satisfactory hemodynamic improvement post-operatively.

    Conclusions:

    • The inter-subclavian bypass is a safe and effective procedure for treating complex proximal subclavian artery or brachiocephalic trunk occlusive disease.
    • Successful outcomes are associated with careful patient selection, particularly regarding the condition of the origin and supply arteries.
    • This technique offers a valuable option for patients with limited therapeutic alternatives.