[Femoro-axillary bypass--a rarely used form of revascularization in occlusions of the supra-aortic vessels].

Revascularization of central occluded supraaortic vascular branches is more and more successfully done by extra-anatomic junction to the nearest other supraaortic vessel. In case of extreme stenosis of all supraaortic donor vessels intrathoracic surgery may be excluded in poor risk patients. The only possibility of extra-anatomic junction remains connection to iliaco-femoral vessels according to the well known femoro-axillary bypass. Showing two typical cases, this method is demonstrated proving its importance in elective and emergency surgery. The first patient (67 yrs. of age) showed an acute complete ischemia of the right arm due to obstruction of the subclavian artery distal of the origin of the truncus brachiocephalicus. Emergency operation was performed, and revascularization was achieved by femoro-axillary bypass because of biological inoperability to all other orthopic procedures. The second case is of a 66 yrs. old patient with abdominal aortic aneurysm and multiple stenoses of the supraaortic vessels. The abdominal aortic aneurysm was electively operated upon, and during the same operation the cerebral circulation was hemodynamically improved by performing a femoro-subclavian bypass. In considering these two cases, indications, risks and benefits of extra-anatomic revascularization procedures are discussed.