Surgical bypass from the left common carotid artery to the left subclavian artery: Infraclavicular approach

Abstract

To create an optimal landing zone (zone 2) in the aortic arch for concomitant or subsequent thoracic endovascular aortic repair of aortic diseases (aneurysm, dissection), surgeons frequently need to debranch the supra-aortic vessels. We present in this video tutorial an alternative to our video tutorial for surgical debranching of the left subclavian artery in which we used a central approach. When the proximal left subclavian artery is dissected or shows dense adhesions around its proximal, centrally located section, it can be helpful to stretch this bypass to the infraclavicular part of the left subclavian artery.

Keywords: Carotid to subclavian bypass; Infraclavicular; Left common carotid artery; Left subclavian artery.