Carotid-axillary artery bypass: a ten-year experience.
OBJECTIVE
The purpose of this study was to review our 10-year experience with carotid-axillary artery bypass in the treatment of occlusive lesions of the proximal subclavian artery.


METHODS
Our 10-year experience with 26 carotid axillary bypasses for occlusive disease of the subclavian artery was reviewed retrospectively. The review focused on the indication for the operation, the surgical technique used, and the development of immediate and late postoperative complications. Long-term bypass graft patency and clinical success were determined on the basis of information gleaned from the office records of all patients. Only three patients were lost to follow-up at 12, 36, and 38 months.


RESULTS
There were no operative deaths. Two patients had small cervical wound hematomas, and two others experienced transient symptoms of brachial plexus irritation, which subsided spontaneously. Permanent nerve or lymphatic complications did not occur. In a mean follow-up of 47 months, carotid-axillary bypass graft patency was 96%, and 88% of the patients enjoyed symptom-free sustained clinical success.


CONCLUSIONS
This retrospective review demonstrates that a carotid-axillary bypass constructed with ringed synthetic graft material tunneled under the clavicle performs well and can be considered a reasonable alternative to the more standard carotid-subclavian bypass for the same indications.
Division of Vascular Surgery, Union Memorial Hospital, Baltimore, MD, USA.
F J
FJ
Criado
L A
LA
Queral
D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000601:surgery; D001366:Axillary Artery / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D002339:Carotid Arteries / Q000601:surgery*; D005260:Female; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013348:Subclavian Artery; D014654:Vascular Patency