Carotid-axillary bypass: clinical and experimental evaluation.

Successful carotid-axillary bypasses have been performed nine times at Walter Reed Army Medical Center during a six year period starting in 1970. Although this approach has been of particular value in patients with symptomatic posttraumatic subclavian arterial occlusions, in whom local fibrosis creates additional problems is dissection and identification of important structures, carotid-axillary bypasses can also be used for lesions of the subclavian and/or axillary artery including aneurysms, ulcerations with distal embolism, and extensive arteriosclerotic occlusive disease. Our experimental data corroborate the clinical impression that carotid-axillary by-passing can be a safe and successful approach to surgical management of subclavian arterial lesions without creating any major significant hemodynamic derangements.