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Upper extremity bypass grafting. A 15-year experience

C L Mesh¹, W J McCarthy, W H Pearce

¹Department of Surgery, Case Western Reserve University, Cleveland, Ohio.

Archives of Surgery (Chicago, Ill. : 1960)

|July 1, 1993

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Primary upper extremity arterial bypass using venous grafts is a safe and effective procedure for patients with ischemia, offering good long-term survival and graft patency rates.

Area of Science:

Vascular Surgery
Arterial Bypass
Upper Extremity Ischemia

Background:

Upper extremity ischemia poses significant challenges for patient survival and limb salvage.
Arterial bypass is a critical intervention for managing this condition.

Purpose of the Study:

To evaluate the perioperative outcomes, long-term survival, and graft patency of arterial bypass procedures for upper extremity ischemia.

Main Methods:

A retrospective review of 74 patients undergoing 95 upper extremity arterial bypass operations over 15 years.
Life-table analysis was used to assess survival and graft patency at 5-year intervals.

Main Results:

No operative mortality was observed, with a single major amputation.

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Five-year survival rate was 86%, and overall graft patency was 61.2%.

Autogenous venous conduits demonstrated superior patency (70.9%) compared to prostheses (37.7%).

Conclusions:

Primary upper extremity arterial bypass with venous conduits is a safe and durable procedure.
This intervention can be expected to result in prolonged patient survival.