PMID: 9555931Apr 29, 1998Paper

Carotid-subclavian bypass for subclavian artery revascularization: long-term follow-up and effect of antiplatelet therapy

Angiology
T WittwerA Haverich

Abstract

Subclavian artery stenosis is found in up to 25% of supraaortic lesions. Bypass grafting is the procedure of choice but controversies exist concerning the optimal technique and the effect of postoperative antithrombotic therapy on long-term patency. The authors retrospectively analyzed 40 patients with carotid-subclavian bypasses. Stenoses were documented preoperatively by arteriography. Patency was determined by clinical, ultrasound, or arteriographic examinations. Cumulative patency rates were calculated by Kaplan-Meier method and analyzed by Tarone-Ware test. Graft materials were Dacron (32), polytetrafluoroethylene (seven) or saphenous vein (one). Indications for surgery included vertebrobasilar insufficiency (22.5%), upper extremity ischemia (22.5%), and the combination of both (55.0%). Perioperative mortality and morbidity were 2.5% and 10.0%, respectively. Patients were followed up from 0 to 134 months (mean 61+/-39 months). Cumulative 5-year patency rate was 83.3%. Anticoagulation with acetylsalicylic acid (ASA) led to significantly better 5-year patency rates (100%) as compared with the combination of ASA and dipyridamole (64.0%, p=0.013) or no anticoagulation (70.0%, p=0.016). Carotid-subclavian bypass led to excellen...Continue Reading

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Citations

Jul 6, 2000·The Annals of Thoracic Surgery·F F DiemontJ N Fabiani
Jan 18, 2006·Annual Review of Medicine·Philip M MeyersLouis R Caplan
Nov 7, 2012·Annals of Pediatric Cardiology·Scott ChowningUmakumaran Ponniah
Sep 26, 2002·World Journal of Surgery·Ilkka T UurtoJuha P Salenius
Mar 6, 2002·Journal of Vascular Surgery·Claudio S CinàCatherine M Clase
Oct 8, 1999·Stroke; a Journal of Cerebral Circulation·A M MalekV V Halbach

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