Although many areas of atherosclerosis can be treated with wires and stents, rarely a patient will require an upper extremity bypass. The innominate artery is formed by the right common carotid and right subclavian artery. This vessel supplies blood to the right arm and brain. The left subclavian artery supplies blood to the left arm. Often, these vessels can be treated endovascularly using stents and wires. Occasionally, if there is a traumatic event or extensive atherosclerotic or other arterial disease a bypass is necessary. The bypass will originate from healthy artery, sometimes even the aorta itself. In most cases, the patient has had an ultrasound and other imaging prior to proceeding with this procedure. Multiple surgical and endovascular options exist for any one problem. Your vascular surgeon will determine the best course of treatment given your specific anatomy and medical problems.
Patients with atherosclerosis may notice a variety of symptoms as disease progresses. These might include numbness, tingling, or a pale color in the hand or upper extremity with extensive use. This often indicates a decrease in blood flow due to narrowed arteries. The first step in diagnosis is always an ultrasound. Depending on the anatomy and likely etiology computed tomography angiography (CTA) or conventional angiogram may be necessary to delineate anatomy and determine the best bypass sites.Imagine will locate the appropriate healthy artery as the origin of the bypass. The surgeon will sew a tube, ideally of the patient’s own vein, to this area of healthy proximal artery and to the distal target. The distal target should also be relatively free from disease. Most patients notice an almost immediate improvement in symptoms after treatment. However, physical therapy may still be necessary to speed recovery.
There are a number of factors that impact the success rate of an upper extremity bypass including the technique of the surgeon, the other medical problems that might affect the patients, and the extent of disease. When patients look for a surgeon to perform this procedure, the patient needs to find the best vascular surgeon. For patients living on the West coast of Florida from Palm Harbor to Sarasota looking for a leading vascular surgeon, Dr. Jenna Kazil is an accomplished vascular surgeon in Manatee County serving patients at the Florida Surgical Clinic located in Bradenton, FL. Dr. Kazil is a consummate surgical specialist that has the experience necessary to ensure that every patient receives the quality surgical care that they deserve. Everyone should contact Dr. Kazil for all of their general surgery and vascular surgery needs.