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 aortiti s syndrome, retrograde bypass grafting from the femoral or common ilia c artery to the axillary artery resulted in the disappearance of sympt oms. 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 regurgitati on, was treated with a bypass from the left common iliac artery to the left axiliary artery with an 8-mm EPTFE graft. These bypass grafts we re angiographically confirmed to be patent after the operation. When c hanges 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 upper extremities sh owed no consistent changes among the three different positions and was maintained in a stable condition, regardless of the patients' positio ns. Furthermore, graft flow increased while the left arm exercised. Th is finding, together with the clinical efficacy, indicates that this m ode of retrograde bypass grafting may be effective in some selected pa tients with this complicated syndrome.