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- W2029139213 abstract "arteq, to the point of its cntraaacc into thc osscous canal at the C-6 level. Subclavian and vertebral endarterectomy is an alternative techniquc. It requircs a left thoracotomv and is used when associated proximal subclavian art e u stenosis occlusion is to bc addressed. Subclavian cndarterectomv is indicatcd tbr vertcbrobasilar insufficiency symptoms and lcss commonly fbr effi)rt fatigue of the ipsilateral upper cxtrcmity. To approach thc let~ subclavian artcrv thc chcst is opened through a third-interspace anterolatcral thoracotomy. As with thc innominatc lesions, the subclavian atheroma may cxtcnd into thc adjacent aorta, but this is an unusual finding. Although this technique has potentially grcatcr morbidity, with thc passage of time this procedure is proving morc durable than the cervical bypass tcchniques. It is our preferred approach cxcept in patients for whom thoracotomv introduces a prohibitivc risk. If thc subclavian arte U is uncommonly hard and calcificd on palpation, or if thc atheroma cxtcnds past the vcrtebral or into the innominatc artcrics, TEA may not be f~:asiblc. Evcn when the vessel is sof~, thc distal end point may requirc tacking suturcs. The subclavian arte U is a notably fragilc vesscl and must bc handled with grcat carc. ~6 Occlusion of the right subclavian artcry is readily approached through the neck with occasional cxtcnsion into thc upper mediastinum. This can bc accomplished bv a hockey-stick cxtcnsion ovcr thc manubrium stcrnum. Clavicular rcscction is unncccssarv and is cosmetically detbrming. Exposure is facilitatcd by ligation and division of the internal mammary and thyroccrvical arterics." @default.
- W2029139213 created "2016-06-24" @default.
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- W2029139213 date "1985-01-01" @default.
- W2029139213 modified "2023-10-16" @default.
- W2029139213 title "Extra-anatomic bypass for revascularization of occlusive lesions involving the branches of the aortic arch" @default.
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- W2029139213 doi "https://doi.org/10.1016/0741-5214(85)90195-8" @default.
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