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Published on: August 16, 2021
Late axillary artery thrombosis in patients with occluded axillary-femoral bypass grafts
Insights
Late thrombosis of axillary-femoral bypass grafts can jeopardize upper extremity viability months after the graft fails. This rare complication requires careful monitoring and prompt intervention to preserve limb function.
Area of Science:
- Vascular Surgery
- Vascular Complications
- Extra-anatomic Bypass
Background:
- Axillary-femoral bypass grafts are an alternative for aortoiliac occlusive disease.
- These extra-anatomic grafts are generally considered safe and effective with low complication rates.
- Previous reports noted early graft thrombosis leading to upper extremity ischemia or loss.
Abstract:
The axillary-femoral bypass graft is an alternative to direct anatomic procedures for patients with aortoiliac occlusive disease. Touted for its low morbidity and mortality rates, with corresponding improved patency rates, this extra-anatomic procedure has been considered safe and effective. Noncompromising upper extremity ischemia and one case of upper extremity loss, associated with early graft thrombosis, have been reported previously. This article describes two cases of late axillary artery thrombosis, occurring 4 and 6 months after graft thrombosis, which severely jeopardized the viability of the ipsilateral upper extremity. Experience with these patients has shown that a thrombosed axillary-femoral bypass graft may jeopardize the viability of the ipsilateral upper extremity many months after its failure. The absence of information in the literature regarding this complication suggests this is a rare complication of thrombosed axillary-femoral grafts.
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