title: In situ cephalic vein bypasses from axillary to the brachial artery after catheterization injuries.
abstract: The need to bypass to the brachial artery is rare. Over a five-year period, 16 patients had suffered iatrogenic post-catheterization injuries of the upper extremity. We have performed 16 bypasses, in 16 patients, mean age was 65 years (range 47-75), to the brachial artery originating from an artery proximal to the shoulder joint. In all cases, the axillary artery was the donor artery. All bypasses were created by using the cephalic vein with the in situ technique and distal anastomoses were made to a distance-free section of brachial artery. No operative mortality, neurological complications or major upper-extremity amputation was associated with the procedure. Life-long-conduit analysis showed 75% patency in the five-year period. After iatrogenic post-catheterization trauma of arterial system of upper extremity, bypasses from axillary to brachial artery with the cephalic vein with the in situ technique is a safe operation with satisfactory long-term patency.
authors.affiliation: Department of Vascular Surgery, University Hospital Sestre Milosrdnice, 10000 Zagreb, Vinogradska 29, Croatia. narcis.hudorovic@zg.htnet.hr
authors.forename: Narcis
authors.initials: N
authors.lastname: Hudorovic
authors.forename: Ivo
authors.initials: I
authors.lastname: Lovricevic
authors.forename: Zaky
authors.initials: Z
authors.lastname: Ahel
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D000800:Angioplasty, Balloon / Q000009:adverse effects* / Q000295:instrumentation; D001366:Axillary Artery / Q000601:surgery*; D001916:Brachial Artery / Q000293:injuries / Q000601:surgery*; D016121:Brachiocephalic Veins / Q000601:surgery*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007511:Ischemia / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*; D014654:Vascular Patency; D014950:Wounds, Penetrating / Q000209:etiology / Q000601:surgery*