Carotid-Subclavian Bypass in Occlusive Disease of Subclavian Artery: More Important Today than Before
| Autor: | Bayer Cinar, Ergin Eren, Onur Göksel, Mesut Kosem, Ihsan Bakir, Yavuz Enc, Sertac Cicek, Erol Kurç |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Percutaneous medicine.medical_treatment Subclavian Artery Arterial Occlusive Diseases General Biochemistry Genetics and Molecular Biology Coronary circulation Blood vessel prosthesis medicine.artery Angioplasty Occlusion Myocardial Revascularization medicine Humans Anesthesia cardiovascular diseases Subclavian artery Aged Retrospective Studies business.industry Stent General Medicine Middle Aged Blood Vessel Prosthesis Surgery Survival Rate Carotid Arteries Treatment Outcome medicine.anatomical_structure Female Radiology business Vascular Surgical Procedures Artery |
| Zdroj: | The Tohoku Journal of Experimental Medicine. 204:53-62 |
| ISSN: | 1349-3329 0040-8727 |
| DOI: | 10.1620/tjem.204.53 |
| Popis: | After left internal mammary artery graft is anastomosed to the coronary artery, atherosclerotic occlusion of subclavian artery becomes more important, because the vascular segment between the origin of the subclavian artery and the coronary artery becomes a part of the coronary circulation functionally. The subclavian artery occlusion may be treated through percutaneous intervention including balloon angioplasty alone or with stent. But failure of initial treatment by percutaneous intervention is possible especially in some proximal and total occlusions. In those cases, surgical options include extra anatomic reconstruction, anatomic reconstruction with transthoracic approach or redo-coronary artery surgery in patients with coronary steal syndrome. In this retrospective study, the medical records of 66 patients underwent carotid-subclavian bypass under general or local anesthesia between January, 1990 and January, 2003 were reviewed to analyze the early and long-term results of carotid-subclavian bypass with polytetrafluoroethylene grafts. There were no intraoperative mortalities. There were only one peroperative cerebrovascular accident and one death due to myocardial ischemia early in the post-operative period. Over a mean follow up of 96 months (6 month-144 months), thirteen patients died due to various reasons and there were eleven late graft thrombosis. The primary patency rates at 1, 3, 5 and 10 years were 98%, 91%, 83% and 47%, and the overall survival rates at 1, 3, 5 and 10 years were 100%, 95%, 93% and 38%, respectively. Carotid-subclavian bypass with polytetrafluoroethylene grafts is a safe, effective and durable procedure. It can be easily applied even under regional anesthesia when percutaneous intervention is unsuccessful or impossible. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|