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

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Presentation transcript:

Bilateral nonthrombotic subclavian vein obstruction causing upper extremity venous claudication Subhash Thakur, MD, Anthony J. Comerota, MD, FACS, FACC, RVT Journal of Vascular Surgery Volume 52, Issue 1, Pages 208-211 (July 2010) DOI: 10.1016/j.jvs.2010.01.090 Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 1 Phlebography of patient's symptomatic left upper extremity (A) reveals collateral development. (B) Upon abduction, occlusion of the subclavian vein is shown. Journal of Vascular Surgery 2010 52, 208-211DOI: (10.1016/j.jvs.2010.01.090) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 2 (A) Patient's right upper extremity was asymptomatic, but (B) abduction demonstrated occlusion of the subclavian vein with drainage from extensive collaterals. Journal of Vascular Surgery 2010 52, 208-211DOI: (10.1016/j.jvs.2010.01.090) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 3 Operative photograph of the anatomy of the axillary space and thoracic outlet as seen through the transaxillary approach to first rib resection. Journal of Vascular Surgery 2010 52, 208-211DOI: (10.1016/j.jvs.2010.01.090) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 4 Venogram 1 day after left first rib resection following balloon dilation. Journal of Vascular Surgery 2010 52, 208-211DOI: (10.1016/j.jvs.2010.01.090) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 5 (A) Venogram showing preoperative right subclavian vein occlusion (arrow) in hyperabducted position and (B) normal anatomy with restored venous drainage when hyperabducted. Journal of Vascular Surgery 2010 52, 208-211DOI: (10.1016/j.jvs.2010.01.090) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 6 Venogram of left axillosubclavian veins 2 years following left first rib resection. Journal of Vascular Surgery 2010 52, 208-211DOI: (10.1016/j.jvs.2010.01.090) Copyright © 2010 Society for Vascular Surgery Terms and Conditions