[Femoro-axillary bypass in the treatment of subclavian steal syndrome].

Extra-anatomic bypass is a nonanatomic procedure of vascular graft from the donor to the recipient artery. The subclavian or axillary artery is very often used for the revascularization of the lower limbs (axillary-femoral bypass). The usage of the femoral artery for the arm or cerebral revascularization is seldom. The authors describe 74-year old woman with femoral-axillary bypass. The bypass was due to subclavian steel syndrome (cerebral and arm vascular insufficiency). Desobstruction and patch angioplasty of the subclavian artery or aorto-subclavian bypass after, transthoracic approach were a contraindication because of the patients advanced age and subcompensated cardiomyopathy. The authors made no typical extraanatomyc bypasses between branches of the aortic arch (carotidosubclavian, or subclavian-subclavian bypass) because of changes on these arteries (occlusion of the left common carotid artery and stenosis of the innominate artery). This is the reason why the femoroaxillary reconstruction was the only possibility of the cerebral and arm revascularization. The Doppler sonographic and angiographic control examination gave good early, and late results. This case is the confirmation of the good use of this unusual method in surgery of subclavian steel syndrome.