Persistent subclavian artery stenosis following surgical repair of non-union of a fractured clavicle
K.M. Burnand, S. Lagocki, R.P. Lahiri, T.Y. Tang, A.D. Patel and J.M.F. Clarke
Corresponding address:
J.M.F. Clarke, Department of Vascular Surgery, Norfolk & Norwich University Teaching Hospital NHS Foundation Trust, Norfolk, UK.
Email: jim.clarke@nnuh.nhs.uk
Arterial thoracic outlet syndrome (TOS) is a rare vascular abnormality. Its common cause is a cervical rib but it is seldom detected secondary to trauma of the clavicle, particularly in association with surgical repair of a fractured clavicle. An athletic 45-year-old man developed a recurrent ischaemic upper limb after repair to a non-union fractured clavicle. He underwent multiple separate procedures including embolectomy, angioplasty, thrombolysis and subclavian stent insertion. Definitive diagnosis was made using 3D reconstructed computer tomography. He had a subclavian artery stenosis with arm abduction as a result of loss of curvature of the clavicle after orthopaedic reconstructive surgery. The best surgical approach for this problem remains controversial.
Keywords
Thoracic outlet syndrome; 3D CT reconstruction; subclavian artery stenosis.
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