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DOI: 10.1055/s-2007-1020096
Der femoro-axillare Bypass - eine selten genutzte Revaskularisationsform bei Verschlüssen supraaortaler Gefäße
The femoro-axillary Bypass - A Rare Form of Revascularisation used when Supraaortic Vessels are OccludedPublication History
1987
Publication Date:
19 March 2008 (online)
Zusammenfassung
Die Revaskularisation der zentral verschlossenen supraaortalen Gefäße wird zunehmend mit Erfolg durch extraanatomischen Anschluß an das nächstgelegene supraaortale Nachbargefäß ausgeführt. Bei hochgradiger Einengung auch dieser Spendergefäße und hohem Risiko des intrathorakalen Eingriffes ist die Möglichkeit des extraanatomischen Anschlusses an die seitengleiche femoro-iliakale Strombahn im Sinne der Stromumkehr des axillo-femoralen Bypass zu erwägen.
Anhand von zwei ausgewählten Fallbeispielen wird demonstriert, daß das Verfahren des femoro-axillären Bypass sowohl in der elektiven als auch in der Notfallchirurgie seine Bedeutung hat.
Abstract
Revascularization of central occluded supraaortic vascular branches is more and more succesfully done by extraanatomic junetion to the nearest other supraaortic vessel.
In case of extreme stenosis of all supraaortic donorvessels intrathoracic surgery may be exeluded in poor risk patients. The only possibility of extraanatomic junetion remains connection to iliaco-femoral vessels aecording to the well known femoro-axillary bypass. Showing two typical cases, this method is demonstrated proving its importance in elective and emergency surgery.
The first patient (67 yrs. of age) showed an acute complete ischemia of the right arm due to obstruetion of the subclavian artery distal of the origin of the truneus brachioeephalicus. Emergency operation was performed, and revascularization was achieved by femoro-axillary bypass because of biological inoperability to all other orthopic procedures.
The second case is of a 66 yrs. old patient with abdominal aortic aneurysma and multiple stenoses of the supraaortic vessels. The abdominal aortic aneurysma was electively operated upon, and during the same operation the cerebral circulation was hemodynamically improved by performing a femoro-subclavian bypass.
In considering these two cases, indications, risks and benefits of extraanatomic revascularization procedures are discussed.
Key words
Extraanatomic vascular surgery - Occlusion of supraaortic vascular branches - Femoro-axillary bypass