Results of subclavian to carotid artery bypass for occlusive disease of the common carotid artery: A retrospective cohort study.

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Results of subclavian to carotid artery bypass for occlusive disease of the common carotid artery: A retrospective cohort study.

Int J Surg. 2018 Mar 23;:

Authors: Illuminati G, Pizzardi G, Calio' FG, Masci F, Pasqua R, Frezzotti F, Peschillo S

Abstract
BACKGROUND: Optimal treatment of significant atherosclerosis of the common carotid artery (CCA) is not well-defined. The purpose of this study was to evaluate the long-term results of prosthetic subclavian to carotid bypass for occlusive disease of the CCA.
MATERIAL AND METHODS: From January 1994 to December 2015, 45 patients, mean age 67 years, underwent an ipsilateral subclavian to carotid bypass for occlusive disease of the CCA. Thirty-eight patients (84%) presented with neurologic symptoms, including transitory ischemic attacks in 29 cases and minor strokes in 9 cases. The graft material consisted of a 7 mm polytetrafluoroethylene conduit, and the distal anastomosis was done on the carotid bulb in 21 patients, on the internal carotid artery in 19 cases, and on the distal CCA in 5 cases. Median length of follow-up was 58 months. Study endpoints were the combined postoperative stroke/mortality rate, graft infection, overall late survival, freedom from ipsilateral stroke, and graft patency.
RESULTS: Postoperative stroke/mortality rate was 2%. No graft infection was observed throughout follow-up. At 60 months, overall survival, freedom from stroke, and graft patency were 71% (standard error [SE] = 0.07), 98% (SE = 0.02), and 95.5% (SE = 0.06), respectively.
CONCLUSIONS: Subclavian to carotid bypass allows very good patency rates and excellent protection from postoperative and late stroke, remaining a benchmark for any other treatment method.

PMID: 29581047 [PubMed - as supplied by publisher]

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