%0 Journal Article
%T Carotid axillary bypass in a patient with blocked subclavian stents: a case report
%A Tarig I Barakat
%A Louise Kenny
%A Hazim Khout
%A Grace Timmons
%A Vish Bhattacharya
%J Journal of Medical Case Reports
%D 2011
%I BioMed Central
%R 10.1186/1752-1947-5-237
%X A 56-year-old Caucasian woman, a heavy smoker, presented acutely with left arm numbness and pain and blood pressure discrepancies in both arms. A diagnosis of subclavian stenosis was confirmed on the basis of a computed tomographic scan and a magnetic resonance angiogram. The patient had undergone subclavian artery stenting twice, and unfortunately the stents blocked on both occasions. The patient underwent carotid axillary bypass surgery. She had an uneventful recovery and was able to return to a full, normal life.Carotid axillary bypass appears to be a good alternative to carotid subclavian bypass in the treatment of symptomatic proximal stenosis or occlusion of the subclavian artery.Although proximal subclavian artery disease is often asymptomatic, once ischemic or embolic complications occur, surgery may be necessary. Transluminal therapy of lesions of subclavian, innominate and common carotid arteries by balloon angioplasty, with or without stenting, is an increasingly performed procedure, especially in cases of stenosis.Although preliminary data for focal lesions are encouraging, careful reporting of long-term results will be the only way to determine whether these non-surgical endoluminal procedures are sufficiently effective to be offered as reasonable alternatives to the better-proven surgical reconstructions.The use of extrathoracic reconstruction for patients with symptomatic proximal subclavian artery disease is well-established. The carotid subclavian bypass is the commonest surgical procedure in cases in which stenting is not possible.This procedure was first described by Diethrich et al. in 1967 [1], and excellent long-term results have been described in several case series [2-8]Exposure of the subclavian artery carries with it the potential risk of damage to major lymphatic vessels and nerves. Exposure of the axillary artery using the infraclavicular approach is technically easier. The artery is easier to handle, and the wall of the vessel is thicker
%U http://www.jmedicalcasereports.com/content/5/1/237