Posterior Course of an Axillobrachial Cross-over Bypass Graft. A Worthwhile Route in Patients with Axillary Region Infection

Introduction (20×15 cm) that involved the axillary region and extended into the lateral aspect of the subclavicular Extra-anatomic axillo-axillary cross-over bypass grafts region. The infected (bacterial culture positive for Pseudomonas aeruginosa) axillo-axillary bypass graft are a well-established alternative to direct reconstruction of the aortic branches. The situations in which was exposed in the wound. The patient complained of rest pain with loss of the sensibility of the hand. the surgeon may feel the anatomic approach to the aortic arch branches not feasible or ill advised are The systolic blood pressure in the right arm was only 30 mmHg. Angiography showed mid-axillary artery current indications for extra-anatomic axillo-axillary cross-over bypass graft. occlusion but colour Doppler showed moderate stenosis of the ipsilateral common and internal carotid We performed a cross-over axillobrachial bypass graft using a posterior course in a patient affected arteries, thus excluding a reconstruction from these arteries. A subclavian-brachial artery vein graft was with upper-limb-threatening ischaemia and infected subclavicular and axillary wounds due to several atinserted in an uninfected field using a supra-acromial route and the previous prosthesis explanted, but the tempts at vascular reconstruction with take-off from the axillary artery. A bibliographic search of the intergraft soon occluded. A composite right subclavianbrachial bypass graft was then performed. The proxnational literature was reviewed in the Index Medicus between 1966 and February 1999 (Medline on Silverimal and distal anastomoses were left in situ and a prosthetic (expanded polytetrafluoroethylene, 8 mm in Platter, 1966–1999, Silver Platter International N.V., U.S.A.); we think that this is the first report describing diameter) graft was interposed after the resection of the such a posterior course.