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Article
January 1975

ProximalCommon Carotid Axillary Bypass

Author Affiliations

From the University of Southern California Medical School and Los Angeles County-University of Southern California Medical Center, Los Angeles, and Presbyterian Intercommunity Hospital, Whittier, Calif.

Arch Surg. 1975;110(1):126-127. doi:10.1001/archsurg.1975.01360070126023
Abstract

Symptomatic occlusive disease of the proximal portion of the subclavian artery can be managed by several different operative techniques, the most commonly used being the carotid-subclavian bypass. We are submitting a new operative approach: the retroclavicular common carotid axillary bypass technique.

For the past two years we have favored this technique over the carotid-axillary artery approach for the following reasons: The proximal part of the axillary artery is far more superficial than the subclavian and can be readily exposed through an infraclavicular pectoralis major musclesplitting incision. Also, the length of axillary artery available for anastomosis is considerably longer and less fragile than the subclavian artery. The subclavian artery exposure is a deep one, limited by the unyielding clavicle and confined to a very small area of exposure. On the left side, the thoracic duct can present problems of lymphorrhea if it is inadvertently lacerated. With the division of a few

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