ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Subclavian-subclavian bypass in the surgical treatment of subclavian steal syndrome
Ömer Tetik1, Necmettin Yakut2, Serdar Bayrak1, Nagihan Karahan1, Mert Kestelli2, Levent Yılık1, Cengiz Özbek1, Ali Gürbüz1
1İzmir Atatürk Eğitim ve Araştırma Hastanesi Kalp ve Damar Cerrahisi Kliniği, İzmir
2Gazi Hastanesi Kalp ve Damar Cerrahisi Kliniği, İzmir
Background: The efficacy of subclavian-subclavian bypass in the surgical treatment of subclavian steal syndrome was evaluated.

Methods: Subclavian-subclavian arterial bypass was performed in 6 patients (5 men, 1 woman; mean age 61±0.21 years; range 55 to 69 years) with subclavian steal syndrome, between March 2001 and May 2005. Five cases presented with syncope, left upper extremity claudication and exercise-induced vertigo and one patient with angina and left upper extremity claudication. This patient had had internal thoracic artery to left anterior descending artery bypass operation 5 years ago. Physical examination revealed significant difference between the two upper extremity brachial systolic blood pressures. In all cases, aortic arch aortography demonstrated a diffuse segmental occlusion in the proximal subclavian artery. Color Doppler ultrasonography demonstrated retrograde flow in the left vertebral artery. All patients were treated surgically. Subclavian-subclavian bypass was performed in all cases with 8 mm polytetraflouroethylene graft.

Results: No perioperative or postoperative death was observed. Postoperative symptomatic improvement parallelled the abolishment of brachial systolic arterial blood pressure changes. No complications were observed in the postoperative period.

Conclusion: We believe that subclavian-subclavian arterial bypass is a good technique in patients with subclavian steal syndrome and not eligible for angioplasty.

Keywords : Blood vessel prosthesis implantation; coronary vessels; subclavian steal syndrome/surgery
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