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Robert L. Hewitt, MD; Rudolph F. Weichert, III, MD; Theodore Drapanas, MD

AMA Arch Surg. 1970;101(2):155-160.

Abstract
Eighteen of twenty patients with subclavian or innominate artery obstruction experienced episodes of transient cerebral arterial insufficiency; one patient suffered acute stroke and coma; all patients had angiographic evidence of subclavian or innominate artery obstruction; and most were shown to have retrograde flow in a vertebral artery. Two clinical patterns were apparent by arteriographic studies. Six patients had single lesions of a subclavian artery resulting in centrifugal cerebral ischemia. A second group of 14 patients had other significant lesions of either the carotid or vertebral-basilar arterial systems. Carotid-subclavian bypass or aorto-subclavian bypass are the preferred methods of reconstruction of subclavian obstructions. Of these two approaches, the extrathoracic procedure is preferable.

Author Affiliations
New Orleans

From the Department of Surgery, Tulane University School of Medicine and Charity Hospital of Louisiana, New Orleans.

Footnotes
Submitted for publication March 4, 1970.

Read before the 27th annual meeting of the Central Surgical Association, Detroit, Feb 26, 1970.

Reprint requests to Department of Surgery, Tulane University School of Medicine and Charity Hospital of Louisiana, New Orleans 70112 (Dr. Hewitt).

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ABSTRACT