Document Detail


Brachiocephalic revascularization: a comparison between carotid-subclavian artery bypass and axilloaxillary artery bypass.
MedLine Citation:
PMID:  1621229     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sixty-seven patients who underwent carotid-subclavian bypass (CSBP) (28 CSBPs only and eight with carotid endarterectomy) or axilloaxillary artery bypass (n = 31) with polytetrafluoroethylene grafts were followed up for a mean of 69.2 and 71.9 months, respectively. Indications for surgery in the CSBP group included hemispheric transient ischemic attack (TIA)/cerebrovascular accident in five, nonhemispheric TIA in seven, upper extremity ischemia in 15, and combined TIA and arm ischemia in nine patients. In the axilloaxillary artery group, two patients had hemispheric TIA, five had nonhemispheric TIA, 12 had upper extremity ischemia, and 12 had combined TIA and arm ischemia. Graft patency was determined clinically and confirmed by segmental Doppler pressures, duplex ultrasonography, or angiography. The 30-day mortality rate was approximately 3% in both groups. The 30-day complication rate was 3% for the axilloaxillary artery group and 8% for the CSBP group (not statistically significant). Relief of symptoms was achieved in 100% of patients in both groups; however, 20% of the patients in the axilloaxillary artery group had a recurrence of symptoms, in contrast to 5.6% in the CSBP group. The cumulative 10-year primary and secondary patency rates, calculated by life-table analysis, were 66% and 84.6% for the axilloaxillary artery procedures and 93.8% and 93.8% for the CSBP procedures, respectively (statistically significant). Concomitant carotid endarterectomy with CSBP did not influence graft patency. In conclusion, both bypasses have comparable morbidity and mortality rates; however, the CSBP has a statistically significantly better primary patency rate than the axilloaxillary artery bypass. Therefore CSBP should be the procedure of choice and the axilloaxillary artery bypass should be restricted to high-risk patients.
Authors:
A F AbuRahma; P A Robinson; M Z Khan; J H Khan; J P Boland
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Surgery     Volume:  112     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1992 Jul 
Date Detail:
Created Date:  1992-08-03     Completed Date:  1992-08-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  84-91     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, West Virginia University Health Sciences Center, Charleston Area Medical Center.
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MeSH Terms
Descriptor/Qualifier:
Arterial Occlusive Diseases / surgery*
Axillary Artery / surgery*
Brachiocephalic Trunk / surgery*
Carotid Arteries / surgery*
Follow-Up Studies
Humans
Life Tables
Postoperative Complications
Probability
Retrospective Studies
Subclavian Artery / surgery*
Time Factors
Treatment Outcome
Vascular Patency
Vascular Surgical Procedures / methods*
Comments/Corrections
Comment In:
Surgery. 1993 Nov;114(5):993   [PMID:  8236026 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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