Subclavian artery resection and reconstruction for thoracic inlet cancers Elie Fadel, MD, Alain Chapelier, MD, PhD, Emile Bacha, MD, Francois Leroy-Ladurie,

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Presentation transcript:

Subclavian artery resection and reconstruction for thoracic inlet cancers Elie Fadel, MD, Alain Chapelier, MD, PhD, Emile Bacha, MD, Francois Leroy-Ladurie, MD, Jacques Cerrina, MD, Paolo Macchiarini, MD, PhD, Philippe Dartevelle, MD Journal of Vascular Surgery Volume 29, Issue 4, Pages 581-588 (April 1999) DOI: 10.1016/S0741-5214(99)70301-0 Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig 1 Left L-shaped cervicotomy. Skin incision is made from angle of mandible down to sternal notch after anterior border of sternocleidomastoid muscle and is extended horizontally under internal half of the clavicle as far as deltopectoral groove. Journal of Vascular Surgery 1999 29, 581-588DOI: (10.1016/S0741-5214(99)70301-0) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig 2 Invaded left subclavian artery is exposed after division of anterior scalenus muscle over first rib in tumor-free margins. It then is divided proximally and distally. Journal of Vascular Surgery 1999 29, 581-588DOI: (10.1016/S0741-5214(99)70301-0) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig 3 Computed tomographic scan results show 4-cm right non–small cell lung cancer invading thoracic inlet. Tumor is adherent to subclavian artery with clear loss of tissue planes. Journal of Vascular Surgery 1999 29, 581-588DOI: (10.1016/S0741-5214(99)70301-0) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig 4 Arteriogram showing stenosis of right subclavian artery beyond origin of vertebral artery. This lesion is caused by arterial wall invasion by right lung cancer located in thoracic inlet. Journal of Vascular Surgery 1999 29, 581-588DOI: (10.1016/S0741-5214(99)70301-0) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig 5 Life-table analysis graph of subclavian artery revascularization patency rates. Vertical bars indicate standard errors. Journal of Vascular Surgery 1999 29, 581-588DOI: (10.1016/S0741-5214(99)70301-0) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig 6 Life-table analysis graph of survival rates for thoracic inlet cancers invading subclavian artery resection. Vertical bars indicate standard errors. Journal of Vascular Surgery 1999 29, 581-588DOI: (10.1016/S0741-5214(99)70301-0) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig 7 Life-table analysis graph of disease-free survival rates for thoracic inlet cancers invading subclavian artery resection. Vertical bars indicate standard errors. Journal of Vascular Surgery 1999 29, 581-588DOI: (10.1016/S0741-5214(99)70301-0) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions