Concomitant Coronary Artery Bypass Grafting and Subclavian Revascularization

Introduction

In proximal total subclavian artery occlusion and steal syndrome, the upper extremity circulation steals blood flow from the cerebral circulation by means of collateral circulation, resulting in vertebrobasilar insufficiency. Excessive physical activity of the related arm may result in vertigo or a history of syncope.

The most permanent treatment of subclavian artery (SA) lesions is a bypass grafting technique. Segmental endarterectomy may be performed in rare cases of ulcer and localized atherosclerosis with plaque. In proximal SA occlusion, an intrathoracic approach is preferred for the bypass from the thoracic aorta [1]. Carotid-subclavian bypass and subclavian-carotid transposition techniques are also performed as an alternative [2]. Depending on the atherosclerotic etiology, SA lesions may exist with too many concomitant carotid artery and coronary artery lesions. Coronary artery and carotid surgery is given priority in chronic cases.

Combined CABG and subclavian artery revascularization within the same treatment is rare in the literature [3]. We present a case simultaneously treated with CABG and subclavian artery revascularization.

References

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