About 1% of Thoracic Outlet Syndrome (TOS) cases are arterial. It is due to compression of the subclavian artery over the first rib. This case report describes a left subclavian artery compressed by the left anterior scalene muscle. The patient was a 20 years old male complaining of coldness and cyanosis of the left hand upon standing in a military position. We performed the left thoracic outlet decompression from the supraclavicular incision. We preserved it. We resected the left anterior scalene muscle and released the left subclavian artery and then closed the layers in anatomic position. The next day we visited the patient He expressed complete recovery from previous symptoms. His left hand was warm and there was no decrease in radial upon left arm abduction. The supraclavicular approach is a safe and effective approach to treating arterial TOS. It results in good functional outcomes in most patients, and it doesn’t have serious complications. This method can be used as the approach of choice in patients selected properly.
Makhoul RG, Machleder HI. Developmental anomalies at the thoracic outlet: an analysis of 200 consecutive cases. Journal of vascular surgery. 1992 Oct 1;16(4):534-45.
Broderick D, Vassiliou L, Kyzas P. Use of the subclavian vessels for microvascular reconstruction in the vessel-depleted neck. British Journal of Oral and Maxillofacial Surgery. 2021 Jan 1;59(1):114-6.
Hashimoto G, Wada S, Morita T, Tomohara S, Hara K, Kumabe M, et al. Ischemic Stroke Caused by Carotid Stump at the Common Carotid Artery. Internal Medicine. 2020 Dec 1;59(23):3071-4.
Marine L, Valdes F, Mertens R, Kramer A, Bergoeing M, Urbina J. Arterial thoracic outlet syndrome: a 32-year experience. Annals of Vascular Surgery. 2013 Nov 1;27(8):1007-13.
Adson AW, Coffey JR. Cervical rib: a method of anterior approach for relief of symptoms by division of the scalenus anticus. Annals of surgery. 1927 Jun;85(6):839.
Qaja E, Honari S, Rhee R. Arterial thoracic outlet syndrome secondary to hypertrophy of the anterior scalene muscle. Journal of surgical case reports. 2017 Aug;2017(8):rjx158.
Dalio MB, da Silva Filho ER, Barufi MB, Ribeiro MS, Joviliano EE. Contemporary Management of Arterial Thoracic Outlet Syndrome. Annals of Vascular Surgery. 2021 Jul 1;74:42-52.
Sanders RJ, Hammond SL. Management of cervical ribs and anomalous first ribs causing neurogenic thoracic outlet syndrome. Journal of vascular surgery. 2002 Jul 1;36(1):51-6.
Hussain MA, Aljabri B, Al-Omran M. Vascular thoracic outlet syndrome. InSeminars in thoracic and cardiovascular surgery 2016 Mar 1 (Vol. 28, No. 1, pp. 151-157). WB Saunders.
Qaja E, Honari S, Rhee R. Arterial thoracic outlet syndrome secondary to hypertrophy of the anterior scalene muscle. Journal of surgical case reports. 2017 Aug;2017(8):rjx158.
Saberianpour, S., & Jalili Shahri, J. (2022). A Left Subclavian Artery Compressed by Left Anterior Scalene Muscle: A Case Report. Journal of Cardio-Thoracic Medicine, 10(3), 1048-1051. doi: 10.22038/jctm.2022.66287.1389
MLA
Shirin Saberianpour; Jamal Jalili Shahri. "A Left Subclavian Artery Compressed by Left Anterior Scalene Muscle: A Case Report", Journal of Cardio-Thoracic Medicine, 10, 3, 2022, 1048-1051. doi: 10.22038/jctm.2022.66287.1389
HARVARD
Saberianpour, S., Jalili Shahri, J. (2022). 'A Left Subclavian Artery Compressed by Left Anterior Scalene Muscle: A Case Report', Journal of Cardio-Thoracic Medicine, 10(3), pp. 1048-1051. doi: 10.22038/jctm.2022.66287.1389
VANCOUVER
Saberianpour, S., Jalili Shahri, J. A Left Subclavian Artery Compressed by Left Anterior Scalene Muscle: A Case Report. Journal of Cardio-Thoracic Medicine, 2022; 10(3): 1048-1051. doi: 10.22038/jctm.2022.66287.1389
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