Our Experiences With Extra-anatomical Bypass Operations in the Supraaortic Area

Abstract

While extraanatomic bypass operations are the exception for the reconstruction of aortoiliac arteries, for instance if there are cumulative serious risks, an infection or a distinct X-ray damage in the inguinal region, or if the patient has an anus praeter, extraanatomic bypass operations on the supraaortal field can be considered as routine operations today. A summary of literature has shown that, within the past 10 Years, still more than 50% of all occlusions of the large supraaortic main branches were directly, i.e. transthoracically, corrected. Today, there is an evident tendency for the extrathoracic, i.e. extraanatomic, procedure in all vascular surgery centres (2, 3). The operation lethality in case of the axillofemoral bypass is indicated as 7% in the literature (4, 6); for the extraanatomic bypass operations in the supraaortic area it amounts to 0.7%. The low mortality and morbidity rate as well as the relatively positive treatment results encouraged us to extend the indication for an extraanatomic procedure in case of occlusions of the brachiocephalic trunk of the common carotid arteries and the subclavian arteries more and more, and also to include younger patients in this treatment.