Femoral-axillary (Brachial) Artery Bypass for Subclavian Steal Syndrome with Bilateral Subclavian Artery Obstruction

Abstract

A 66-year-old woman presented with complaints of bilateral arm weakness, numbness, and dizziness. Preoperative aortography revealed bilateral subclavian artery obstruction and a patent left vertebral artery with retrograde flow. Coronary angiography did not reveal any significant stenosis. Due to severe diffuse calcification of her thoracic aorta, the patient underwent extra-anatomical bypass grafting from the left common femoral artery to both arteries of the bilateral upper extremities (left axillary artery and right brachial artery), subcutaneously. Her symptoms of subclavian steal syndrome resolved with a patent graft 3 years after surgery. Extra-anatomical bypass grafting with the common femoral artery used as an inflow site may be an alternative procedure for bilateral upper extremity revascularization in patients with severe calcification of the thoracic aorta.