Usefulness of femoro(ilio)-axillar bypass surgery for the treatment of subclavian steal syndrome caused by aortitis syndrome.

In two patients with subclavian steal syndrome associated with aortitis syndrome, retrograde bypass grafting from the femoral or common iliac artery to the axillary artery resulted in the disappearance of symptoms. One patient, a 37-year-old female, was treated with a bypass from the left femoral artery to the left axillary artery with a 10-mm ring-supported double velour knitted Dacron graft. The other patient, a 54-year-old female, with the complication of moderate aortic regurgitation, was treated with a bypass from the left common iliac artery to the left axillary artery with an 8-mm EPTFE graft. These bypass grafts were angiographically confirmed to be patent after the operation. When changes in graft flow in different body positions (supine, sitting, and standing) were examined, using a transcutaneous Doppler flow meter, 5 years after the operation, resting graft flow to the upper extremities showed no consistent changes among the three different positions and was maintained in a stable condition, regardless of the patients' positions. Furthermore, graft flow increased while the left arm exercised. This finding, together with the clinical efficacy, indicates that this mode of retrograde bypass grafting may be effective in some selected patients with this complicated syndrome.