SURGICAL TREATMENT OF SUBCLAVIAN ARTERY OBSTRUCTION

Abstract

During the past 15 years, 36 patients were hospitalized for arterial obstructive disease of the arm other than that arising from aortitis syndrome. Seventeen arterial reconstructions (two being repeat operations) in 15 patients with subclavian artery obstruction were performed with grafts of the great saphenous vein. Here, we review indications for surgery and surgical methods. When the obstruction was due to arteriosclerosis obliterans, we treated surgically only those patients (n=10) in whom the so-called subclavian steal syndrome caused brain ischemia. Axillo-axillary artery bypass was the operation of first choice because it causes less operative stress than the other usual methods, and because we found that the patency rate of the grafts was good. When as was the case for five patients with brachial plexus injury, revascularization was necessary, and we planned the operative method according to the region of obstruction. That is, when the obstruction was at the origin of subclavian arteries, carotid-subclavian artery bypass was performed. When the obstruction was at the distal part, vein transplantation was carried out. All grafts were patent and results were satisfactory in all five patients.