title: The potential risk for upper extremity thromboembolism in patients with occluded axillofemoral bypass grafts: two case reports.
abstract: Axillofemoral bypass grafts (AxFG) are widely used in the management of poor-risk patients with aortoiliac occlusive disease. On the other hand, AxFGs are associated with a variety complications to the upper extremity (UE). UE thromboembolism represents a significant and specific complication of occluded AxFGs in our series (2.6% of patients, 33.3% of occluded grafts). This article describes two cases of late axillary artery thrombosis caused by the occlusion of externally-supported AxFGs. The two patients were treated by graft disconnection, a distal embolectomy, and patch angioplasty of the axillary artery. Their postoperative courses were uneventful. Based on the authors' experience and a review of the literature, they suggest that an occluded AxFG represents a high risk for use of a donor artery and that such patients must therefore be very carefully followed. To prevent late UE thromboembolism in patients with occluded grafts, the authors strongly advise that such patients undergo a surgical operation with careful follow-up after surgery.
authors.affiliation: Department of Surgery, Fukuoka City Hospital, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Mawatari
authors.forename: Y
authors.initials: Y
authors.lastname: Muto
authors.forename: S
authors.initials: S
authors.lastname: Funahashi
authors.forename: T
authors.initials: T
authors.lastname: Ikeda
authors.forename: K
authors.initials: K
authors.lastname: Komori
authors.forename: K
authors.initials: K
authors.lastname: Sugimachi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000098:blood supply*; D001366:Axillary Artery / Q000601:surgery*; D005263:Femoral Artery / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000150:complications* / Q000601:surgery*; D006801:Humans; D008297:Male; D012307:Risk Factors; D013923:Thromboembolism / Q000453:epidemiology* / Q000209:etiology; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000009:adverse effects*