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The Potential Risk for Upper Extremity Thromboembolism in Patients with Occluded Axillofemoral Bypass Grafts

Two Case Reports

Department of Surgery, Fukuoka City Hospital, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Yoichi Muto, MD

Department of Surgery, Fukuoka City Hospital, Faculty of Medicine, Kyushu University, Fukuoka, Japan; The Department of Surgery, Fukuoka City Hospital,13.1 Honmachi Yoshizuka, Hakataku, Fukuoka 812-0046 Japan

Satoru Funahashi, MD

Toshihiko Ikeda, MD

Department of Surgery, Fukuoka City Hospital, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Kimihiro Komori, MD

Keizo Sugimachi, MD, FACS

Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Axillofemoral bypass grafts (AxFG) are widely used in the management of poor-risk patients with aortoiliac occlusive disease. On the other hand, AxFGs are associated with a variety complications to the upper extremity (UE). UE thromboembolism represents a significant and specific complication of occluded AxFGs in our series (2.6% of patients,33.3% of occluded grafts). This article describes two cases of late axillary artery thrombosis caused by the occlusion of externally-supported AxFGs. The two patients were treated by graft disconnection, a distal embolectomy, and patch angioplasty of the axillary artery. Their postoperative courses were uneventful. Based on the authors' experience and a review of the literature, they suggest that an occluded AxFG represents a high risk for use of a donor artery and that such patients must therefore be very carefully followed. To prevent late UE thromboembolism in patients with occluded grafts, the authors strongly advise that such patients undergo a surgical operation with careful followup after surgery.

Vascular and Endovascular Surgery, Vol. 35, No. 1, 67-71 (2001)
DOI: 10.1177/153857440103500114


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