Retroclavicular Carotid-Axillary Bypass: A Step-by-Step Guide

Optimally, coverage of the left subclavian artery orifice should be revascularized. The most widely used method of carotid subclavian bypass is associated with morbidities related to nerve and thoracic duct injuries that are not uncommon. It is more commonly done by a vascular surgeon. Carotid-axillary bypass is an alternative that is equally effective, safer for the phrenic nerve and the thoracic duct, and easy for cardiac surgeons to perform due to more familiar anatomy and exposure.

In this video, the authors present their technique for carotid subclavian bypass. The method includes using a retroclavicular route and left subclavian embolization in the context of zone II TEVAR.