March 1959

Aortic-Carotid Bypass Prothesis in Treatment of "Pulseless Disease"Report of a Case

Author Affiliations

New Brunswick, N. J.
From the Medical and Vascular Services, St. Peter's General Hospital.; Senior Attending Physician (Dr. Silber); Senior Attending Surgeon (Dr. Rosenberg).

AMA Arch Surg. 1959;78(3):372-375. doi:10.1001/archsurg.1959.04320030016003

Thrombo-obliterative disease of the branches of the aortic arch, also known as "pulseless disease," or Takayasu's disease,1 is a condition of uncertain etiology, characterized by a lack of pulsation in one or more of the major branches of the aortic arch and ischemic manifestations in the area of distribution of the occluded vessels.

Surgical correction of this condition has been attempted in eight cases. Two were reported by Shimizu and Sano,2 who attempted thrombectomy through the sacrificed external carotid artery in one case and resected the carotid bifurcation, using a venous homograft between the common and internal carotid arteries in a second case. Thromboendarterectomy was performed in five cases.3-6 The first instance of surgical correction employing a bypass was reported by De Bakey and co-workers.4 Treatment was directed toward relief of claudication in the upper extremity, and a nylon bifurcation prosthesis was implanted from the aorta

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