PMID: 8967152Jan 1, 1996Paper

Supra-aortic bypasses for revascularization of the subclavian artery: early and late results of extra-thoracic and transthoracic methods: are extra-anatomic conduits superior?

VASA. Zeitschrift für Gefässkrankheiten
T WittwerT Wahlers

Abstract

Subclavian artery stenosis is found in up to 25% of patients with supraaortic lesions. Bypass grafting is the recommended procedure of choice but there is still debate concerning the optimal technique. We therefore performed a retrospective analysis to determine the prognostic factors based on long-term results. Between 1974 and 1992, fifty-five patients were treated for subclavian artery stenosis. The methods used were carotid-subclavian artery bypass (KSBP, n = 40) and aorto-subclavian artery bypass (ASBP, n = 15). Indications for surgery included vertebrobasilar insufficiency (20.0%), upper extremity ischemia (20%) and the combination of both (58.2%). Arteriosclerosis was the predominant cause of disease (85.5%). Peri-operative mortality was limited to one patient in the KSBP-group (2.5%). Post-operative morbidity was significantly lower in the KSBP-group (10.0%) as compared to the ASBP-group (40.0%, p = 0.018). Relief of symptoms was achieved in 97.4% of KSBP procedures and in 92.9% of ASBP procedures. Patients were followed up for a mean period of 73.7 +/- 58.0 months. Cumulative 5-year patency rates of 71.4% (ASBP) and 83.3% (KSBP) were not significantly different between both groups (p = 0.089). Pharmacologic therapy wit...Continue Reading

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