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Upper extremity thromboembolism after axillary-axillary bypass grafting
R B McLafferty1, L M Taylor, G L Moneta
1Department of Surgery, Oregon Health Sciences University, Portland 97201-3098, USA.
Cardiovascular Surgery (London, England)
|February 1, 1996
Summary
Axillary-axillary bypass grafting (AxAG) for subclavian artery stenosis can lead to upper extremity thromboembolism. Early recognition and tailored treatment, including anticoagulation or graft revision, are crucial for managing these complications.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Thromboembolic Disease
Background:
- Subclavian artery stenosis can cause significant upper extremity symptoms.
- Axillary-axillary bypass grafting (AxAG) is a surgical option for treating symptomatic subclavian artery stenosis.
- Thromboembolic complications following AxAG require careful consideration.
Observation:
- Two patients developed upper extremity thromboembolism after undergoing AxAG.
- The first patient experienced left-sided thromboembolism 3 years post-AxAG with a PTFE graft, treated successfully with warfarin.
- The second patient had right-sided thromboembolism 4 years after AxAG with a Dacron graft, requiring graft revision with a saphenous vein graft.
Findings:
- AxAG, particularly with synthetic grafts, may be associated with delayed thromboembolic events.
- Thrombus formation at the anastomosis or graft occlusion can lead to distal embolization.
- Treatment strategies vary, including anticoagulation and surgical intervention.
Implications:
- This case series highlights the potential risk of thromboembolism after AxAG.
- Vigilant long-term surveillance for thromboembolic complications is recommended for patients undergoing AxAG.
- Individualized treatment approaches are necessary for managing post-AxAG thromboembolism.
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