stenosis >50% was found in 0% and 33% (P ¼ .0474) of patients in the infraclavicular and supraclavicular approaches, respectively. Infraclavicular thoracic outlet decompression was associated with fewer postoperative symptoms, 0 (0%) vs 8 (53.3%; P ¼ .0022), and infraclavicular thoracic outlet decompression demonstrated superior patency, 15 (100%) vs 8 (66.7%; P ¼ .0282). In addition, there was a trend toward fewer reinterventions in the infraclavicular group, 0.27 6 0.8 vs 0.87 6 1.5 (P ¼ .1984). Mean combined follow-up was 8.47 6 10.8 months. Conclusions: Infraclavicular thoracic outlet decompression for the surgical management of VTOS was associated with fewer postoperative symptoms and superior axillosubclavian vein patency compared with the supraclavicular approach. Prospective analysis is warranted to determine long-term outcomes after infraclavicular decompression.

Axillary artery aneurysms are well documented and have potentially severe or life-threatening complications [1-3]. While pseudoaneurysms of the axillary artery can be caused by trauma or iatrogenic complications, true aneurysms are often due to repeated blunt trauma to the axillary artery over time, leading to weakening of the artery wall. The most common example is prolonged crutch use, though some athletes who have repetitive forceful movement of the upper limb, such as baseball players, may also be at risk [3]. Rarer causes include degenerative disorders such as Marfan’s syndrome or inflammatory diseases such as vasculitis [2]. Potential complications of axillary artery aneurysms include neurologic or vascular compromise of the involved upper extremity. Here we report the rare case of a patient presenting with concurrent acute cerebellar stroke and critical limb ischemia as embolic complications of axillary artery aneurysm.

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