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- Title
Long-Term Outcome of Carotid-Subclavian Bypass in the Management of Coronary-Subclavian Steal Syndrome.
- Authors
Wenkel, Martin; Halloum, Nancy; Izzat, Mohammad Bashar; Ali-Hasan-Al-Saegh, Sadeq; Duerr, Georg Daniel; Kriege, Marc; Stamenovic, Davor; Treede, Hendrik; El Beyrouti, Hazem
- Abstract
Objective: The presence of a significant left subclavian artery stenosis may occasionally lead to blood flow reversal through a LIMA-to-coronary artery bypass graft during left arm exertion; with "stealing" of myocardial blood supply. The aim of this study was to review our experience with carotid-subclavian bypass in patients with post-CABG coronary-subclavian steal syndrome. Methods: This is a retrospective review of all patients who underwent carotid-subclavian bypass grafting for post-CABG coronary-subclavian steal syndrome at Mainz University Hospital between 2006 and 2015. Cases were identified in our institutional database, and data were retrieved from surgical records, imaging studies, and follow-up records. Results: Nine patients (all males, mean age of 69.1 years) underwent surgical treatment for post-CABG coronary-subclavian steal syndrome. Medium interval between original CABG and carotid-subclavian bypass grafting was 86.1 months. There were no perioperative deaths, strokes or myocardial infarctions. At a mean follow-up period of 79.9 months, all patients remained asymptomatic and all carotid-subclavian bypass grafts remained patent. One patient required stenting of a common carotid artery stenosis proximal to the graft anastomosis site, and coronary artery stenting was required in four patients in regions other than those supplied by the patent LIMA graft. Conclusion: Carotid-subclavian bypass surgery is a safe treatment option even in patients with multivessel disease and severe comorbidities and should be taken into consideration in patients who are deemed fit for surgery and those who would benefit from the excellent long-term patency rates.
- Subjects
CAROTID artery surgery; SUBCLAVIAN artery surgery; CORONARY artery bypass; RETROSPECTIVE studies; SURGICAL complications; TREATMENT effectiveness; POSTOPERATIVE period; DESCRIPTIVE statistics; SUBCLAVIAN steal syndrome; PATIENT safety
- Publication
Vascular & Endovascular Surgery, 2024, Vol 58, Issue 1, p29
- ISSN
1538-5744
- Publication type
Article
- DOI
10.1177/15385744231186272