Luosto R, Ketonen P, Harjola P T, Järvinen A
Scand J Thorac Cardiovasc Surg. 1980;14(2):227-31. doi: 10.3109/14017438009101004.
One hundred extrathoracic arterial reconstructions were performed on 98 patients with occlusions or stenoses of the subclavian or vertebral arteries: 52 bypasses, 18 transpositions of the subclavian artery to the common carotid artery, 13 endarterectomies and 17 operations involving two or more simultaneous reconstructions. The operative mortality was 1% (one patient). In 2 patients hemiplegia occurred as a complication of carotid-subclavian bypass operation. Six patients had a nerve injury as an operative complication: 1 lesion of the brachial plexus, 3 lesions of the recurrent nerve, and two lesions of the phrenic nerve (one patient also had Horner's syndrome). Immediate thrombosis of the operated arteries developed in 7 patients, 2 of whom were re-operated on. During the follow-up period (mean 4.5 years), six additional operations were performed because of failure of the first operation: the bypass graft was thrombosed in 5 of these cases and in one case a venous bypass graft with insufficient flow was replaced by a prosthesis. One patient underwent reconstruction of the contralateral side because of residual symptoms. In addition, 1 carotid endarterectomy, 2 thoracic sympathectomies, 4 coronary artery reconstructions and 8 lower limb arterial reconstructions were performed during the follow-up period. There were 17 late deaths, 9 of which were due to coronary artery disease. Of the 80 survivors 79% were satisfied with the operative result. The bypass was considered patent in 68%.
对98例锁骨下动脉或椎动脉闭塞或狭窄患者进行了100次胸外动脉重建术：52例旁路移植术，18例锁骨下动脉转位至颈总动脉，13例动脉内膜切除术，17例涉及两个或更多同时重建的手术。手术死亡率为1%（1例患者）。2例患者因颈动脉 - 锁骨下动脉旁路手术出现偏瘫并发症。6例患者出现神经损伤作为手术并发症：1例臂丛神经损伤，3例喉返神经损伤，2例膈神经损伤（1例患者还患有霍纳综合征）。7例患者出现手术动脉即刻血栓形成，其中2例再次手术。在随访期（平均4.5年），因首次手术失败又进行了6次手术：其中5例旁路移植血管血栓形成，1例静脉旁路移植血管血流不足被假体替代。1例患者因残留症状进行了对侧重建。此外，随访期间进行了1例颈动脉内膜切除术、2例胸交感神经切除术、4例冠状动脉重建术和8例下肢动脉重建术。有17例晚期死亡，其中9例死于冠状动脉疾病。在80名幸存者中，79%对手术结果满意。68%的旁路被认为通畅。
