Margruder C. Donaldson, M. D. , William H. Druckemiller, M. D

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Presentation transcript:

Use of the transverse cervical artery with indwelling shunt for subclavian-vertebral bypass Margruder C. Donaldson, M.D., William H. Druckemiller, M.D., Bruce C. Zablow, M.D. Journal of Vascular Surgery Volume 2, Issue 6, Pages 917-920 (November 1985) DOI: 10.1016/0741-5214(85)90144-2 Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 A, Lateral projection: left common carotid artery injection showing total occlusion of left internal carotid artery at its origin (arrow) with retrograde filling of left carotid siphon (s) via ophthalmic collateral anastomosis between sphenopalatine branches of left internal maxillary artery and ophthalmic artery. B, Lateral projection: left carotid (late phase) showing filling of distal cervical and intracranial segment of left vertebral artery (arrow) via muscular collateral branches of left occipital artery. This isolated vertebral artery terminates in left posterior inferior cerebellar artery. No delayed filling of distal extracranial left internal carotid artery is noted. Journal of Vascular Surgery 1985 2, 917-920DOI: (10.1016/0741-5214(85)90144-2) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 Anteroposterior projection of right common carotid injection shows patent anterior communicating artery and cross filling of left anterior and middle cerebral vessels. No filling of either posterior cerebral artery is noted. Journal of Vascular Surgery 1985 2, 917-920DOI: (10.1016/0741-5214(85)90144-2) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3 A, Anteroposterior projection of innominate artery injection showing occlusion of proximal portion of right vertebral artery (arrow) with reconstitution of proximal cervical segment of right vertebral (v) via small collateral branches of costocervical trunk. B, Later phase of innominate artery injection showing right vertebral artery (V) supplying basilar artery (B) and both posterior cerebral arteries without retrograde flow into distal left vertebral artery. Journal of Vascular Surgery 1985 2, 917-920DOI: (10.1016/0741-5214(85)90144-2) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 A, Placement of plastic cannula from subclavian artery (s) through inferior branch of thyrocervical trunk through cut end of transverse cervical branch (t) in preparation for temporary shunting to vertebral artery (v). B, Position of shunt in distal end of opened vertebral artery during anastomosis. C, Completed subclavian-vertebral bypass with transverse cervical artery after withdrawl of shunt from inferior branch of thyrocervical trunk. Journal of Vascular Surgery 1985 2, 917-920DOI: (10.1016/0741-5214(85)90144-2) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions