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Vascular and Endovascular Surgery
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Coronary-Subclavian Steal with Concomitant Carotid Disease: Indication for Axilloaxillary Bypass

A Case Report

David R. Jones

Department of Surgery, West Virginia University School of Medicine

Ronald C. Hill

Department of Surgery, West Virginia University School of Medicine

C. Andrew Heiskell

Department of Surgery, Monongalia General Hospital

Michael J. Hollingsed

Department of Surgery, West Virginia University School of Medicine

Michael O'Keefe

Department of Cardiology, Monongalia General Hospital, Morgantown, West Virginia

Mark G. Nelson

Department of Surgery, West Virginia University School of Medicine

Coronary-subclavian steal syndrome is a potential complication of coronary artery bypass grafting when the internal mammary artery is used as a conduit. Concomitant carotid artery disease complicates the syndrome by introducing a possible simultaneous cerebral steal phenomenon. The authors present the first reported case of a patient who had symptomatic coronary-subclavian steal with significant carotid occlusive disease. An axilloaxillary bypass was performed instead of the standard carotid-subclavian bypass. Recommendations concerning the diagnosis and management of this syndrome are presented and the indication for axilloaxillary bypass is outlined.

Vascular and Endovascular Surgery, Vol. 28, No. 1, 51-56 (1994)
DOI: 10.1177/153857449402800108
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