Tratamiento quirúrgico del Síndrome del Opérculo Torácico. Abordaje supra e infraclavicular

  1. Lara-Quintana, Arkaitz 1
  2. Hernando-Rydings, Manuel 2
  3. Jiménez-Maestre, Unai 3
  4. Bravo- Ruiz, Esther 2
  5. Veja-Manrique, Reyes 2
  6. Pac-Ferrer, Joaquín 3
  1. 1 Servicio Vasco de Salud-Osakidetza. Organización Sanitaria Integrada Bilbao – Basurto. Hospital Universitario Basurto. Servicio de Cirugía Ortopédica y Traumatología. Bilbao, España.
  2. 2 Servicio Vasco de Salud-Osakidetza. Organización Sanitaria Integrada Bilbao – Basurto. Hospital Universitario Basurto. Servicio de Angiología y Cirugía Vascular. Bilbao, España.
  3. 3 Servicio Vasco de Salud-Osakidetza. Organización Sanitaria Integrada Ezkerraldea – Enkarterri – Cruces. Hospital Universitario Cruces. Servicio de Cirugía Torácica. Barakaldo, España.
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Journal:
Gaceta médica de Bilbao: Revista oficial de la Academia de Ciencias Médicas de Bilbao. Información para profesionales sanitarios

ISSN: 0304-4858,  2173-2302

Year of publication: 2023

Volume: 120

Issue: 3

Pages: 133-137

Type: Article

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More publications in: Gaceta médica de Bilbao: Revista oficial de la Academia de Ciencias Médicas de Bilbao. Información para profesionales sanitarios

Abstract

The Thoracic Outlet Syndrome is a rare entity with multiple presentations. The most frequently involved structures are nervous, venous and arterial. Its origin in the scalene muscle and in the cervical ribs are the most common etiologies.We present the case of a 37 year-old male reporting pain, coldness, paresthesias and pallor in his upper right limb. The angioCT revealed stenosis of the subclavian artery associated with a cervical rib. In addition, associated repletion defects were also observed in the humeral artery. The patient underwent surgery following a supra and infraclavicular approach to have the cervical and the first thoracic ribs resected, along with a subclavian-axillary internal saphenous vein bypass. Two years later, the patient is asymptomatic.The supra and infraclavicular approach, allows us to have an excellent intraoperative field to resect the ribs and for revascularization, without increasing the complications.

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