Iliac-subclavian-internal carotid artery bypass for cerebral ischemia due to multiple proximal supra-aortic vessel obstruction (aortic arch syndrome).

Severe cerebral ischemia was successfully treated in a patient with arteriosclerotic aortic arch syndrome by an iliac-subclavian-internal carotid artery bypass, using an extra-anatomic modified Dacron prosthesis externally coated with collagen. The procedure and material seem suitable for managing high-risk patients who have critically stenotic or occluded branches of the aortic arch and who would not tolerate anatomic, transthoracic repair.