Atherosclerosis remains a significant health problem despite advances in medication. Although most patients with subclavian stenosis are asymptomatic, those who are symptomatic will usually have symptom relief with stent placement. However, for some patients stent placement may not be possible. An alterative open procedure is a bypass from the common carotid artery to the subclavian artery using a prosthetic conduit.
This procedure was more common prior to advances in endovascular therapies. Currently, most of these procedures are performed prior to endovascular repair of thoracic aneurysms (TEVAR), which often require coverage of the subclavian artery for adequate treatment. Carotid subclavian bypass is performed several days prior to aneurysm repair to ensure adequate blood flow to the upper extremity should the subclavian artery be covered. Alternatively, if aneurysm repair is emergent carotid subclavian bypass can be performed after aneurysm repair if needed.
The procedure itself requires a small incision above the clavicle. The carotid and subclavian arteries are skeletonized and a bypass is sewn from one artery to the other. A drain is usually placed and the subcutaneous tissues and skin are closed. Patients can usually go home the following day if the patient has no complications.
Patients requiring vascular surgery should look for the best board-certified physician trained in vascular surgery. Dr. Jenna Kazil is one of Manatee County’s finest surgeons. Dr. Kazil has completed a general surgery residency as well as a vascular surgery fellowship. She is a double board-certified vascular surgeon currently working at Florida Surgical Clinic in Bradenton, FL.