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Treatment With Axilloaxillary Bypass

Richard I. Weiner, MD; Ralph A. Deterling, Jr, MD; Joanna Sentissi, MD; Thomas F. O'Donnell, Jr, MD

Arch Surg. 1987;122(8):876-880.

Abstract
• Twenty patients underwent axilloaxillary bypass at Tufts—New England Medical Center, Boston, between 1973 and 1983, all for tight stenosis or occlusion of the subclavian artery. Review of records was possible for 19 cases. Symptoms included intermittent claudication and numbness of the upper extremity, as well as dizziness, vertigo, and ataxia due to episodes of vertebrobasilar insufficiency. Dacron, reversed saphenous vein, and polytetrafluoroethylene grafts were inserted, with all but one occupying a subcutaneous tunnel across the sternum. There were no operative deaths, and morbidity was minimal. The median follow-up was 83 months. The early patency rate was 94%, with a cumulative patency rate of 89% at ten years of follow-up, as determined by the life-table method. Our experience supports axilloaxillary bypass as a safe and effective treatment for symptomatic subclavian artery insufficiency.

(Arch Surg 1987;122:876-880)

Author Affiliations
From the Department of Surgery, Tufts University School of Medicine, New England Medical Center Hospital, Boston.

Footnotes
Accepted for publication March 16, 1987.

Read before the 13th Annual Meeting of the New England Society for Vascular Surgery, Dixville Notch, NH, Sept 26, 1986.

Reprint requests to the Department of Surgery, New England Medical Center Hospital, 171 Harrison Ave, Boston, MA 02111 (Dr O'Donnell).

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