> Details

Wittwer, Thorsten; Wahlers, Thorsten; Dresler, Christoph; Haverich, Axel

Carotid-Subclavian Bypass for Subclavian Artery Revascularization: Long-term Follow-up and Effect of Antiplatelet Therapy

Reference
management

Bookmarks

Remove from
bookmarks

Share this on Whatsapp

Close

Bookmarks



You can manage bookmarks using lists, please log in to your user account for this.
  • Media type: E-Article
  • Title: Carotid-Subclavian Bypass for Subclavian Artery Revascularization: Long-term Follow-up and Effect of Antiplatelet Therapy
  • Contributor: Wittwer, Thorsten; Wahlers, Thorsten; Dresler, Christoph; Haverich, Axel
  • Published: SAGE Publications, 1998
  • Published in: Angiology, 49 (1998) 4, Seite 279-287
  • Language: English
  • DOI: 10.1177/000331979804900406
  • ISSN: 0003-3197; 1940-1574
  • Origination:
  • Footnote:
  • Description: Subclavian artery stenosis is found in up to 25% of supraaortic lesions. Bypass grafting is the procedure of choice but controversies exist concerning the optimal technique and the effect of postoperative antithrombotic therapy on long-term patency. The authors retrospectively analyzed 40 patients with carotid-subclavian bypasses. Stenoses were documented preoperatively by arteriography. Patency was determined by clinical, ultrasound, or arteriographic examinations. Cumulative patency rates were calcu lated by Kaplan-Meier method and analyzed by Tarone-Ware test. Graft materials were Dacron (32), polytetrafluoroethylene (seven) or saphenous vein (one). Indications for surgery included vertebrobasilar insufficiency (22.5%), upper extremity ischemia (22.5%), and the combination of both (55.0%). Perioperative mortality and morbidity were 2.5% and 10.0%, respectively. Patients were followed up from 0 to 134 months (mean 61 ±39 months). Cumulative 5-year patency rate was 83.3%. Anticoagulation with acetylsalicylic acid (ASA) led to significantly better 5-year patency rates (100%) as compared with the combination of ASA and dipyridamole (64.0%, p=0.013) or no anticoagulation (70.0%, p=0.016). Carotid-subclavian bypass led to excellent long-term patency rates and can provide durable relief of symptoms with minimal perioperative morbidity and mortality. Therefore, it is a worthwile procedure to correct proximal subclavian artery stenosis. Postoperative medication with ASA seems to increase long-term bypass function significantly.