Carotid to subclavian bypass, rare but rewarding surgery: A case report

Abstract

Different treatment options are available for subclavian stenosis (SS). Carotid to subclavian bypass surgery (CSBS) is an increasingly used effective treatment strategy when stenting is impossible. However, in Nepal, little is known about SS and its management. A 58-year-old man with a history of aortic valve replacement surgery complained of progressive left arm weakness for the past 6 months associated with pain on exertion and blood pressure discrepancies in both arms. A computed tomographic scan confirmed near-complete subclavian artery stenosis and a Doppler ultrasound showed decreased blood flow and systolic velocity. CSBS was selected as stenting was not feasible. Post-CSBS, all hemodynamic parameters returned to normal, lasting even after 2 years. CSBS appears to be a viable, safe, and promising treatment for symptomatic SS. However, additional studies need to be conducted to analyze the benefits of CSBS relative to other interventions.