The spectrum of arterial compression at the thoracic outlet

Slides:

Advertisements

Similar presentations

Subhash Thakur, MD, Anthony J. Comerota, MD, FACS, FACC, RVT

Advertisements

A review of 100 consecutive reconstructions of the distal vertebral artery for embolic and hemodynamic disease Ramon Berguer, MD, PhD, Mark D. Morasch,

Vascular Thoracic Outlet Syndrome

Arterial injuries in the thoracic outlet syndrome

Reporting standards of the Society for Vascular Surgery for thoracic outlet syndrome Karl A. Illig, MD, Dean Donahue, MD, Audra Duncan, MD, Julie Freischlag,

Two case presentations and surgical management of Bow Hunter's syndrome associated with bony abnormalities of the C7 vertebra Victoria Lee, BS, Thomas.

Kathleen M. Lamb, MD, Julia Glaser, MD, Phillip Dowzicky, MD, Paul J

Reporting standards of the Society for Vascular Surgery for thoracic outlet syndrome Karl A. Illig, MD, Dean Donahue, MD, Audra Duncan, MD, Julie Freischlag,

Raghuveer Vallabhaneni, MD, Jeffrey Jim, MD, Colin P

Mohammed Al-Omran, MD, MSc Journal of Vascular Surgery

Vascular Thoracic Outlet Syndrome

Aortic arch involvement worsens the prognosis of type B aortic dissections R. James Valentine, MD, Julia M. Boll, MD, Kyle M. Hocking, PhD, John A. Curci,

Kathleen M. Lamb, MD, Julia Glaser, MD, Phillip Dowzicky, MD, Paul J

Positional compression of the axillary artery causing upper extremity thrombosis and embolism in the elite overhead throwing athlete Yazan M. Duwayri,

John Westley Ohman, BS, Kristofer M

Mycotic axillary artery aneurysm

Renal artery stenosis and aneurysms associated with neurofibromatosis

Suboccipital approach to the distal vertebral artery

Diagnosis of thoracic outlet syndrome

Tongue necrosis as an unusual presentation of carotid artery stenosis

Surgical bypass vs endovascular treatment for patients with supra-aortic arterial occlusive disease due to Takayasu arteritis Young-Wook Kim, MD, Dong-Ik.

Successful coil embolization for rupture of the subclavian artery associated with Ehlers- Danlos syndrome type IV Yasunori Iida, MD, PhD, Yukio Obitsu,

John W. Fehrenbacher, MD, Robert A. McCready, MD

Xiaobai Wang, MD, Yan Zhang, MD, Chengzhi Li, MD, Hong Zhang, MD

Axillary artery compression and thrombosis in throwing athletes

Thoracic outlet syndrome caused by first rib hemangioma

Volume 15, Issue 3, Pages (March 2008)

Endovascular stent graft for symptomatic mobile thrombus of the thoracic aorta Philipp Fueglistaler, MD, Thomas Wolff, MD, Lorenz Guerke, MD, Peter Stierli,

The first operation on the profunda femoris artery

The hybrid elephant trunk procedure: A single-stage repair of an ascending, arch, and descending thoracic aortic aneurysm Ali Azizzadeh, MD, Anthony.

Arterial injuries in the thoracic outlet syndrome

Bilateral first rib resection and scalenectomy is effective for treatment of thoracic outlet syndrome Danielle H. Rochlin, BA, Megan S. Orlando, BA,

Thoracic endovascular aortic repair of aortobronchial fistulas

Erik E. Swensson, M. D. , Vallee L. Willman, M. D. , Gary J

Multiple congenital ectatic and fusiform arterial aneurysms associated with lower limb hypoplasia Juan Carlos Lopez-Gutierrez, MD, PhD, Laura Cadenas.

Chandu Vemuri, MD, Lauren N. McLaughlin, ACNP, Ahmmad A

Joshua I. Greenberg, MD, RPVI, Kristen Alix, NP, Mark R

Migration of endovascular plug in hybrid repair of dysphagia lusoria

Contemporary outcomes after distal vertebral reconstruction

The challenge of posttraumatic thrombus embolization from abdominal aortic aneurysm causing acute limb ischemia Gianluigi Nigro, MD, Luca Giovannacci,

The significance of cervical ribs in thoracic outlet syndrome

Michael R. Corey, MD, Emel A. Ergul, MS, Richard P

Angiolymphoid hyperplasia involving large arteries

Combination treatment of venous thoracic outlet syndrome: Open surgical decompression and intraoperative angioplasty Darren B. Schneider, MD, Paul J.

Aortic arch aneurysm associated with coarctation and absence of the main branches of left subclavian artery Zhenghua Xiao, MD, Hong Qian, MD, Eryong.

Vascular Thoracic Outlet Syndrome

Ioana Antonescu, MD, MSc, Katharine L. McGinigle, MD, Jason R

Suboccipital approach to the distal vertebral artery

Unusual etiology of upper extremity ischemia in a scleroderma patient: Thoracic outlet syndrome with arterial embolization Beate Hugl, MD, W. Andrew.

Successful treatment of multiple mycotic aortic aneurysms, using a hybrid procedure Yasunori Iida, MD, PhD, Yukio Obitsu, MD, PhD, Yoshihiko Yokoi, MD,

Endovascular treatment of ruptured axillary and large internal mammary artery aneurysms in a patient with Marfan syndrome Jessica F. Rose, DO, Layla.

Journal of Vascular Surgery

Aneurysms of the mid axillary artery in major league baseball pitchers—A report of two cases George J. Todd, MD, Alan I. Benvenisty, MD, Stuart Hershon,

Coil embolization of persistent false lumen after stent graft repair of type B aortic dissection Enrique María San Norberto, MD, Vicente Manuel Gutiérrez,

Arterial complications of the thoracic outlet syndrome: Fifty-five operative cases Jean Michel Cormier, MD a, Mohand Amrane, MD a, Antony Ward, MS b,

Robert A. McCready, MD, M. Ann Bryant, MSN, RN, BC, ACNP, Janet L

Migration of endovascular plug in hybrid repair of dysphagia lusoria

Ramyar Gilani, MD, Roy K. Greenberg, MD, Douglas R. Johnston, MD

Isolated celiac artery dissection

Subhash Thakur, MD, Anthony J. Comerota, MD, FACS, FACC, RVT

Upper extremity arterial injury in athletes

Massive upper gastrointestinal bleeding due to a ruptured superior mesenteric artery aneurysm duodenum fistula Jichun Zhao, MD, PhD Journal of Vascular.

Boonprasit Kritpracha, MD, Anthony J. Comerota, MD,

Ignacio Hernández-Lahoz, MD, Raul Garcia-Casas, MD

Francesco Spinelli, MD, Francesco Stilo, MD, PhD

Rebecca Jeanmonod, MD, Chad Lewis, MD Journal of Vascular Surgery

Robert J. Rizzo, MD, William R. Flinn, MD, James S. T

Seizures following subclavian-carotid bypass

Intimal intussusception: Unusual complication of dissecting aneurysm

P. Joshua O'Brien, MD, Shalini Ramasunder, MD, Mitchell W. Cox, MD

Presentation transcript:

The spectrum of arterial compression at the thoracic outlet Enrique Criado, MD, Ramon Berguer, MD, PhD, Lazar Greenfield, MD Journal of Vascular Surgery Volume 52, Issue 2, Pages 406-411 (August 2010) DOI: 10.1016/j.jvs.2010.03.009 Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 1 Arch arteriogram depicts a left subclavian aneurysm with a luminal filling defect. This patient presented with upper extremity embolization without preexisting symptoms. Journal of Vascular Surgery 2010 52, 406-411DOI: (10.1016/j.jvs.2010.03.009) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 2 A selective right subclavian arteriogram demonstrates an almost complete arterial occlusion with arm abduction, without a cervical rib or other bone anomaly. The arteriogram was normal in the neutral position. The patient had chronic upper extremity symptoms difficult to differentiate from neurogenic thoracic outlet syndrome. He underwent first rib resection and neurolysis of the brachial plexus, with complete resolution. Journal of Vascular Surgery 2010 52, 406-411DOI: (10.1016/j.jvs.2010.03.009) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 3 A selective right subclavian artery arteriogram shows a complete axillary artery occlusion with the arm abducted 90° and externally rotated. The humeral head is compressing the axillary artery. The patient presented with tingling and numbness of his hand and arm that interfered with his work as an automobile mechanic. The patient underwent mobilization of the artery, freeing it from multiple fibrotic attachments to the aponeurotic tissues overlying the humeral head. This was followed by complete resolution of the symptoms. Journal of Vascular Surgery 2010 52, 406-411DOI: (10.1016/j.jvs.2010.03.009) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 4 A selective left subclavian arteriogram reveals subtle luminal filling defects without poststenotic dilatation. This patient presented with limb-threatening acute ischemia from embolization. In retrospect, the patient recognized a history of ill-defined preexisting arm symptoms. Journal of Vascular Surgery 2010 52, 406-411DOI: (10.1016/j.jvs.2010.03.009) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 5 A selective left subclavian arteriogram demonstrates moderate compression of the subclavian artery with mild poststenotic dilatation in the presence of a cervical rib. The patient had signs and symptoms that were difficult to differentiate from neurogenic thoracic outlet syndrome. The symptoms resolved after cervical rib resection and neurolysis of the brachial plexus. Journal of Vascular Surgery 2010 52, 406-411DOI: (10.1016/j.jvs.2010.03.009) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 6 Top, A computed tomography (CT) 3-dimensional reconstruction shows left subclavian arterial dilatation without stenosis in the neutral position and without a cervical rib or other bone anomaly. Bottom, A repeat CT scan with the arm abducted shows complete occlusion of the subclavian artery. This case illustrates how postural compression of the subclavian artery at the thoracic outlet produces distal dilatation in the same way that fixed arterial stenoses do. Journal of Vascular Surgery 2010 52, 406-411DOI: (10.1016/j.jvs.2010.03.009) Copyright © 2010 Society for Vascular Surgery Terms and Conditions