Surgical management of brachioaxillary-subclavian vein occlusion.
OBJECTIVE
The possibility of using RING PTFE graft as venous bypass to preserve arteriovenous graft function and reduce upper extremity swelling.


METHODS
Twenty-two patients with stenosis/occlusion of the brachial-axillary-subclavian vein segment in haemodialysis patients (n = 19) and patients with penetration injury (n = 3) who were not candidates for balloon angioplasty were treated with ring PTFE venous bypass in renal patients and jugular to axillary vein transposition for trauma patients and followed for 10-87 months (mean 31) using venography, Doppler analysis and Duplex scanning.


RESULTS
There was no death or neurologic deficit resulting from the venous bypass. Resolution of swelling occurred in 8-48 h. 19/22 (86%) of the bypasses and 3/3 transpositions remained patent after a mean follow-up of 31 months (10-87) months. The attrition was due to AV graft occlusion (n = 2) and infection requiring graft removal (n = 1).


CONCLUSIONS
Ring PTFE graft is an acceptable venous bypass for brachial-axillary-subclavian stenosis/occlusion to reduce arm swelling and preserve the function of AV grafts in patients with lesions not amendable with balloon angioplasty or thrombolytic therapy. Jugular-axillary transposition is inappropriate for renal patients.
Sottiurai
V S
VS
Department of Surgery, Louisiana State University School of Medicine, New Orleans 70112-2822, USA.
Lyon
R
R
Ross
C
C
Cooper
M
M
Gonzales
J
J
D000328:Adult; D000368:Aged; D001132:Arm / Q000098:blood supply*; D001367:Axillary Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000379:methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000601:surgery; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D011138:Polytetrafluoroethylene; D011859:Radiography; D013350:Subclavian Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D014680:Veins / Q000601:surgery
D011138:Polytetrafluoroethylene