Large-vessel arterial occlusive disease in symptomatic upper extremity
R. W. Harris, G. Andros, L. B. Dulawa, R. W. Oblath, S. X. Salles-Cunha and R. Apyan
Subclavian and axillary artery occlusive disease resulted in sufficient
upper extremity symptoms to necessitate 30 vascular reconstructions in 28
patients over the past ten years. Female patients predominated, with a
ratio of 2.5:1. The average age of the patients was 61 years. The incidence
of diabetes mellitus was low (7%). Sixteen of 18 proximal subclavian
lesions were on the left side, while more distal lesions were equally
distributed on the left and right. Extrathoracic bypasses were used in all
cases. Dacron grafts were used in 16 of 17 carotid-subclavian bypasses.
Autogenous vein grafts were used in 11 of 13 bypasses to the axillary or
brachial artery. Concomitant cervicodorsal sympathectomy was done in only
four patients. The in-hospital graft patency rate was 93% and the long-term
graft patency rate at one year and beyond was 88%.
