Axillo-axillary bypass grafting for proximal subclavian artery obstructions
AbstractThe current popular method of surgical correction of symptomatic proximal subclavian arterial occlusions by carotid-subclavian bypass, although it has given good results in several reported series, is not without hazard. Operative manipulation of the carotid vessel, which includes clamping, placing of intraluminal shunts, and construction of suture lines from which adherent platelet or fibrin thrombus may embolise, carries a definite risk of postoperative stroke. An alternative reconstruction, which does not involve the carotid artery at all, would seem preferable. Axillo-axillary bypass grafting is a safe and effective method of revascularising the distal subclavian vessel and of treating the subclavian steal syndrome. The procedure is simple to perform and has not been associated with any significant side-effects in the cases followed-up to date, and is recommended when the surgeon has any doubt about using a carotid vessel in his reconstruction procedure.
S. Afr. Med. J. 48, 2174 (1974).
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