Preferences help
enabled [disable] Abstract
Number of results
2012 | 84 | 3 | 158-162
Article title

Critical Upper Limb Ischemia Caused by Initially Undiagnosed Thoracic Outlet Syndrome - Case Report

Title variants
Languages of publication
A case of a progressive ischemia of the right upper extremity in a 57-year-old male caused by primarily undiagnosed compression of a subclavian artery by an accessory cervical rib is presented. Critical limb ischemia persisting for 7 years despite conservative treatment and a thrombectomy of upper extremity arteries and thoracic sympathectomy, led to a loss of three fingers and development of a non-healing ulceration of right upper extremity. Eventually a cervical rib resection together with a subclavio-brachial venous bypass graft permanently reversed the critical limb ischemia and allowed the ulceration to heal.The presented case underscores the importance of an early surgical intervention in patients with upper limb ischemia and anatomic abnormalities in a thoracic outlet.
Physical description
1 - 2 - 2012
28 - 5 - 2012
  • Department of General and Vascular Surgery, Medical University in Poznań
  • Department of General Surgery with Services of Oncological and Vascular Surgery, Specialist Hospital in Piła
  • Department of General and Vascular Surgery, Medical University in Poznań
  • Cervi E, Bonardelli S, Battaglia G et al.: Upper limb artery segmental occlusions due to chronic use of ergotamine combined with itraconazole, treated by thrombolysis. Thromb J 2011; 9: 13.
  • Criado E, Berguer R, Greenfield L: The spectrum of arterial compression at the thoracic outlet. J Vasc Surg 2010; 52(2): 406-11.[PubMed][WoS][Crossref]
  • Pietrzak K, Góral M, Drążkiewicz M: Zastosowanie stentu samorozprężalnego w leczeniu niedrożności tętnicy podobojczykowej - opis przypadku. Chirurgia Polska 2011; 13(1): 75-82.
  • Olin JW: Thromboangiitis obliterans (Buerger's disease). N Engl J Med. 2000; 343: 864-69.
  • Piazza G, Creager MA: Thromboangiitis obliterans. Circulation 2010; 121(16): 1858-61.[WoS]
  • Roos DB: Historical perspectives and anatomic considerations. Thoracic outlet syndrome. Semin Thorac Cardiovasc Surg 1996; 8(2): 183-89.[PubMed]
  • Murphy JB: A case of cervical rib with symptoms resembling subclavian aneurysm. Ann Surg 1905; 41: 399-406.
  • Mayo H: Exostosis of the first rib with strong pulsations of the subclavian artery. Lon Med Phy J (NS) 1831; 11: 40.
  • Durham JR, Yao JS, Pearce WH et al.: Arterial injuries in the thoracic outlet syndrome. J Vasc Surg. 1995; 21(1): 57-69.[Crossref]
  • Dzieciuchowicz Ł, Szczęśniak A, Staniszyc M i wsp.: Zmiany przepływu krwi w kończynie górnej w zależności od ustawienie kończyny w stawie ramiennym. Acta Angiologica 1995; 1(1): 31-34.
  • Dunant J.H: Neue Aspekte uber Atiologie, Diagnose und chirurgische Therapie des Schultergurtelsyndroms. VASA 1979; 8: 167.
Document Type
Publication order reference
YADDA identifier
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.