[Aneurysmal degeneration of the autovenous carotid-subclavian bypass: experience with the treatment, review of literature].

The authors describe an experience gained with successful surgical treatment of a 73-year-old patient with a genuine aneurysm of the autoveinous carotid-subclavian bypass, iwelve years ago the patient was operated on for stenosing atherosclerosis of the coronary and left subclavian arteries (SCA). Aneurysm emergence was consequent on the use of v.saphena magna as a bypass in the given <<position>> and was not associated with appreciable circulatory disorders in the left upper limb. However, its further existence was conjugated with the risk of rupture and bleeding. Examination (duplex scanning, angiography) confirmed the diagnosis of aneurysm. Besides, critical stenosis of segment I of the left SCA and opening of the left internal carotid artery (ICA) were verified as well. The patient was operated on: the first stage involved angioplasty and stenting of segment I of the left SCA; the second stage involved carotid endarterectomy on the left, resection of bypass aneurysm together with its disengagement. On control angiography performed 11 months later the patency of the reconstructed arteries appeared satisfactory; stenosis was not recorded. The given case demonstrates a modern approach to the treatment of patients with coexistent vascular pathology (atherosclerotic stenosis plus aneurysm).