Objective: Our goal was to evaluate the long-term results of vein bypass gr
afts for axillary artery occlusion, specifically those placed extra-anatomi
cally to prevent arterial injury in pitchers.
Methods: With the greater saphenous veins used as the selected conduit, art
erial bypass grafts were routed anterior to the pectoralis minor muscle in
four baseball pitchers who had occlusion of the axillary artery. We perform
ed a follow-up in excess of 10 years with evaluations of the bypass grafts
by ultrasonic duplex scan and magnetic resonance angiography.
Results: All four pitchers treated in this manner returned to the game and
played for several seasons without a recurrence of the arterial injury. Lon
g-term evaluation of the bypass grafts did not reveal any structural or fun
Conclusions: Axillary artery occlusion in an athlete can be effectively tre
ated with a vein bypass graft placed extra-anatomically, anterior to the pe
ctoralis minor muscle. The greater saphenous vein should be considered the
conduit of choice.