ABSTRACT
Three patients with subclavian artery obstruction caused by arteriosclerosis underwent surgical reconstruction based on their specific anatomic characteristics. Subclavian artery transposition was performed in a patient with a short segmental occlusion of the proximal subclavian artery. The patient with a long segmental occlusion, from the origin of the internal thoracic artery to the origin of the thoracoacrominal artery, underwent bypass-grafting between common carotid artery and axillary artery. The graft was passed lateral to the anatomical tract to prevent compression by the scalenus and subclavian muscles. Because the branchial plexus also can be compressed in the thoracic outlet, the scalenus muscles were detached at the first rib in both methods. It is important to consider the specific cause of subclavian artery occlusion when planning corrective surgery. Ischemic and neurologic symptoms improved using both techniques.