Purpose: The purpose of this study was to review our 10-year experienc
e with carotid-axillary artery bypass in the treatment of occlusive le
sions of the proximal subclavian artery. Methods: Our 10-year experien
ce with 26 carotid axillary bypasses for occlusive disease of the subc
lavian artery was reviewed retrospectively. The review focused on the
indication for the operation, the surgical technique used, and the dev
elopment of immediate and late postoperative complications. Long-term
bypass graft patency and clinical success were determined on the basis
of information gleaned from the office records of all patients. Only
three patients were lost to follow-up at 12, 36, and 38 months. Result
s: There were no operative deaths. Two patients had small cervical wou
nd hematomas, and two others experienced transient symptoms of brachia
l plexus irritation, which subsided spontaneously. Permanent nerve or
lymphatic complications did not occur. In a mean follow-up of 47 month
s, carotid-axillary bypass graft patency was 96%, and 88% of the patie
nts enjoyed symptom-free sustained clinical success. Conclusions: This
retrospective review demonstrates that a carotid-axillary bypass cons
tructed with ringed synthetic graft material tunneled under the clavic
le performs well and can be considered a reasonable alternative to the
more standard carotid-subclavian bypass for the same indications.