Upper Extremity Bypass for Chronic Ischemia—A National Surgical Quality Improvement Program Study Database Study

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.