Carotid-axillary Bypass for Subclavian Atery Occlusion with Gaining Access through the Axillary Fossa: Report of One Case

ABSTRACT

Some representative operative techniques have been introduced for treating subclavian artery stenosis or occlusion: carotid-subclavian bypass, carotid-subclavian interposition and axillo-axillary bypass. But the cases of carotid-axillary bypass are rare and moreover, carotid-axillary bypass with gaining access through the axillary fossa are rare in the medical literature. A 77-year-old man who had left upper arm claudication that was aggravated when he performed some hand movements like buttoning-up or undoing buttons visited our hospital. The upper extremity computed tomography angiography showed a 4-centemeter-long occlusion of the left subclavian artery, which began at the point passed by the bulb of the vertebral artery. We performed carotid-axillary bypass between the left axillary artery at the axillary fossa and the left common carotid artery at the left neck at the anterior aspect of the sternocleidomastoid muscle. This operation could be a feasible alternative modality for a patient with occlusion of a long distal segment of the subclavian artery.