Axilloaxillary bypass for the treatment of subclavian artery stenosis complicated by bilateral common carotid artery occlusion: technical case report.
OBJECTIVE
We successfully treated a patient with stenosis of the left subclavian artery, complicated by bilateral common carotid artery occlusion, via axilloaxillary bypass surgery.


METHODS
A 67-year-old patient with a history of hypertension and cerebral infarction underwent neck irradiation for treatment of a vocal cord tumor. Three months later, he began to experience transient tetraparesis several times per day. The blood pressure measurements for his right and left arms were different. Supratentorial blood flow was markedly low. The common carotid arteries were bilaterally occluded, and the right vertebral artery was hypoplastic. Therefore, only the left vertebral artery contributed to the patient's cerebral circulation; his left subclavian artery was severely stenotic.


METHODS
The patient underwent axilloaxillary bypass surgery because the procedure avoids thoracotomy or sternotomy, manipulation of the carotid artery, and interruption of the vertebral artery blood flow. The patient has been free of symptoms for more than 5 years.


CONCLUSIONS
Neurosurgeons should be aware that extra-anatomic bypass surgery is an effective treatment option for selected patients with cerebral ischemia.
Ogino
Masahiro
M
Department of Neurosurgery, Saiseikai Utsunomiya Hospital, Mibu, Tochigi, Japan. oginom-dky@umin.ac.jp
Nagumo
Masashi
M
Nakagawa
Toru
T
Nakatsukasa
Masashi
M
Murase
Ikuro
I
D000368:Aged; D001366:Axillary Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000601:surgery*; D016893:Carotid Stenosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D002533:Cerebral Angiography; D002548:Cerebral Revascularization; D006801:Humans; D008297:Male; D013349:Subclavian Steal Syndrome / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D015899:Tomography, Emission-Computed, Single-Photon