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October 1966

Single Anastomosis Vein Bypass for Subclavian Vein Obstruction

Author Affiliations

From the Department of Surgery, New York University School of Medicine (Dr. Smith), and Bellevue Hospital (III and IV Divisions) (Capt Witte), New York. Capt Witte is presently at USAF Hospital Scott, Scott Air Force Base, Ill.

Arch Surg. 1966;93(4):664-666. doi:10.1001/archsurg.1966.01330040128025

PROLONGED success of a peripheral venous anastomosis in man is rare. Occlusion commonly follows techniques designed to relieve chronically obstructed deep veins by interposition of autogenous or synthetic grafts with double anastomoses.1,2

In this report a single anastomotic venovenous shunt successfully bypassed a subclavian vein obstruction which had developed during union of a fractured clavicle. Patency of the internal jugulosubclavian venovenous shunt was confirmed by angiography nine months after surgery.

Report of Case  A 45-year-old Negro laborer was admitted to the Bellevue Hospital prison ward four months after sustaining a displaced, middle one third fracture of the left clavicle. The initial injury was treated at another hospital with a "figure-of-eight" bandage for three weeks and then unrestricted activity. A prominent callus accompanied healing, and four weeks after injury pain and swelling in the left arm appeared. During the next three months he complained of progressive edema and severe pain

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