Single Anastomosis Vein Bypass for Subclavian Vein Obstruction

Abstract

PROLONGED success of a peripheral venous anastomosis in man is rare. Occlusion commonly follows techniques designed to relieve chronically obstructed deep veins by interposition of autogenous or synthetic grafts with double anastomoses.^1,2 In this report a single anastomotic venovenous shunt successfully bypassed a subclavian vein obstruction which had developed during union of a fractured clavicle. Patency of the internal jugulosubclavian venovenous shunt was confirmed by angiography nine months after surgery. Report of Case A 45-year-old Negro laborer was admitted to the Bellevue Hospital prison ward four months after sustaining a displaced, middle one third fracture of the left clavicle. The initial injury was treated at another hospital with a "figure-of-eight" bandage for three weeks and then unrestricted activity. A prominent callus accompanied healing, and four weeks after injury pain and swelling in the left arm appeared. During the next three months he complained of progressive edema and severe pain