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William O. Myers, MD; Ben R. Lawton, MD; Jefferson F. Ray, III, MD; Marvin E. Kuehner, MD; Richard D. Sautter, MD

Arch Surg. 1979;114(4):394-399.

Abstract
• Since 1972, 14 patients with subclavian steal and four with primary vascular insufficiency of the arm have been operated on using the axillo-axillary bypass graft. Two grafts have been replaced, one after nine months for threatened erosion, and the other after three years for thrombosis due to disease progression in the donor artery. The new grafts were patent at three and at 2 years. One graft was occluded at six months and was not replaced. All other patients under observation in 1978 have grafts patent at one month to 6 years (average 2.2 years). Life table analysis shows the probability of graft patency (20 grafts) is 76% at three years. In the subclavian steal group steal on the left side predominated 2:1. Cerebral symptoms predominated with arm symptoms less often seen, although six patients had both. Associated vascular disease and hypertension were common. There was no mortality and few complications. Axillo-axillary bypass grafting is considered the operation of choice for patients with subclavian steal syndrome.

(Arch Surg 114:394-399, 1979)

Author Affiliations
From the Department of Surgery, the Marshfield Clinic and Marshfield Medical Foundation, Inc, Marshfield, Wis.

Footnotes
Accepted for publication Dec 19, 1978.

Read before the 86th annual meeting of the Western Surgical Association, Scottsdale, Ariz, Nov 13, 1978.

Reprint requests to Department of Surgery, Marshfield Clinic, 1000 N Oak Ave, Marshfield, WI 54449 (Dr Myers).

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