Abstract
A 67-year-old man, who had suffered from right cerebral infarction that resulted in left hemiparesis, underwent right superficial temporal artery-middle cerebral artery anastomosis in 1991. From March 2000, dizziness occurred during use of his right hand. His arteriogram revealed late filling of the occluded right subclavian artery by reversed flow from the right vertebral artery and 50% stenosis of the left internal carotid artery. We performed subcutaneous axillo-axillary bypass grafting with mild hypothermia on June 1st, 2000. An 8mm ePTFE tube with a ring was anastomosed to both axillary arteries in end-to-side fashion with continuous sutures. Thereafter, symptoms disappeared. One month after the procedure, his arteriogram showed that the bypass filled the right vertebral artery in an antegrade fashion as well as the right axillary artery. Axillo-axillary bypass grafting with mild hypothermia seemed to be safe and effective for high-risk subclavian steal syndrome.
