Axilloaxillary bypass for the treatment of subclavian artery stenosis complicated by bilateral common carotid artery occlusion: Technical case report

Masahiro Ogino, Masashi Nagumo, Toru Nakagawa, Masashi Nakatsukasa, Ikuro Murase, H. Hunt Batjer, Michael T. Lawton, Robert A. Solomon

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

OBJECTIVE AND IMPORTANCE: We successfully treated a patient with stenosis of the left subclavian artery, complicated by bilateral common carotid artery occlusion, via axilloaxillary bypass surgery. CLINICAL PRESENTATION: A 67-year-old patient with a history of hypertension and cerebral infarction underwent neck irradiation for treatment of a vocal cord tumor. Three months later, he began to experience transient tetraparesis several times per day. The blood pressure measurements for his right and left arms were different. Supratentorial blood flow was markedly low. The common carotid arteries were bilaterally occluded, and the right vertebral artery was hypoplastic. Therefore, only the left vertebral artery contributed to the patient's cerebral circulation; his left subclavian artery was severely stenotic. INTERVENTION: The patient underwent axilloaxillary bypass surgery because the procedure avoids thoracotomy or sternotomy, manipulation of the carotid artery, and interruption of the vertebral artery blood flow. The patient has been free of symptoms for more than 5 years. CONCLUSION: Neurosurgeons should be aware that extra-anatomic bypass surgery is an effective treatment option for selected patients with cerebral ischemia.

Original languageEnglish (US)
Pages (from-to)444-447
Number of pages4
JournalNeurosurgery
Volume53
Issue number2
DOIs
StatePublished - Aug 1 2003

Keywords

  • Cerebral ischemia
  • Laryngeal carcinoma
  • Radiotherapy
  • Vertebral artery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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