Subclavian artery stenosis caused by a prominent first rib

Abstract

Thoracic outlet syndrome is a mechanical space problem in which the brachial plexus and/or subclavian vessels are compressed. Arterial compression is least common and almost always associated with a bony anomaly. We present a case of a 49-year-old woman with a prominent first rib which caused a subclavian artery stenosis. There are many options for subclavian artery repair through open surgery. In high-risk patients, minimal invasive techniques are favorable. To date, few case reports exist on an endovascular artery repair combined with open first rib resection. While long-term follow-up will be necessary, our preliminary results seem promising.

Thoracic Outlet Syndrome with Subclavian Artery Thrombosis Caused by Synostosis of the First and Second Ribs

“…Treatment depends on the clinical presentation. It is usually conservative in cases of bone anomalies without an aneurysm, except when symptoms exist 41 . When a poststenotic dilatation or aneurysm is present, a resection of the first rib should be performed.…”

“…In addition, late thromboembolic events have not been reported 29,36,[45][46][47]52 . In case of aneurysms >2 cm in diameter, intima damage, or thrombus, additional subclavian artery repair or replacement may be necessary 41 .…”