Upper extremity bypass for chronic ischemia--a national surgical quality improvement program study database study

Vasc Endovascular Surg. 2013 Apr;47(3):192-4. doi: 10.1177/1538574413478472. Epub 2013 Feb 20.

Abstract

Objective: We undertook this study to determine the outcomes of upper extremity arterial reconstruction for chronic ischemia.

Methods: The National Surgical Quality Improvement Program Database was queried to identify all patients who had undergone an upper extremity bypass for chronic ischemia between 2005 and 2007.

Results: A total of 55 patients were identified in a primarily female population (71% women). Mean age was 57. The most common preoperative diagnoses included ischemia resulting from prior arterial thromboembolism in 16 (29%) patients and atherosclerotic upper extremity arterial disease in 11 (20%) patients. The most common procedures performed included axillo-brachial bypass in 17 (31%) patients, brachial-brachial bypass in 11 (20%) patients, and carotid-brachial bypass in 11 (20%) patients. There were no perioperative deaths and no acute graft failures.

Conclusion: Although upper extremity bypass remains rare, the procedures appear to be safe with excellent 30-day results. Indications differ from those for lower extremity bypass.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arteries / surgery
  • Chi-Square Distribution
  • Chronic Disease
  • Databases, Factual
  • Female
  • Humans
  • Ischemia / diagnosis
  • Ischemia / surgery*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Selection
  • Plastic Surgery Procedures* / adverse effects
  • Postoperative Complications / etiology
  • Quality Improvement*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • United States
  • Upper Extremity / blood supply*
  • Vascular Grafting* / adverse effects
  • Young Adult