Post-Traumatic Thoracic Outlet Syndromes

Casbas, Laurent; Chauffour, Xavier; Cau, Jérôme; Bossavy, Jean-Pierre; Midy, D.; Jc, Baste; Barret, A

doi:10.1007/s10016-004-0151-1

Cited by 34 publications

(27 citation statements)

References 10 publications

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“…8,9 It can also be caused by repetitive use of the upper limb, as occurs in some professional and sporting activities. Arterial complications caused by post-traumatic pseudarthrosis are uncommon, [3][4][5][6][7] but can be severe.…”

Section: Discussionmentioning

confidence: 99%

“…Arterial complications caused by post-traumatic pseudarthrosis are uncommon, [3][4][5][6][7] but can be severe. 8 The mechanism of injury is the result of chronic constriction of the subclavian artery and repeated microtraumas. There are four clinical variants of arterial injury: thrombosis, microemboli, and formation of aneurysms 7,8 and pseudoaneurysms.…”

Section: Discussionmentioning

confidence: 99%

“…8 The mechanism of injury is the result of chronic constriction of the subclavian artery and repeated microtraumas. There are four clinical variants of arterial injury: thrombosis, microemboli, and formation of aneurysms 7,8 and pseudoaneurysms. 10 The most common form is a combination of aneurysm of the subclavian artery and distal embolization.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment with open vascular surgery should therefore be considered the first management option, since the open incision is needed for removal of the bone deformity. 7,8 Endovascular treatments, such as, for example, pharmacological or pharmacomechanical thrombolysis, are of questionable value in these cases. Even if the thrombolytic treatment achieves satisfactory results in terms of dissolving acute and subacute thrombi, the underlying arterial injury should only be treated after removal of the bone deformity.…”

Section: 11mentioning

confidence: 99%

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Compressão da artéria subclávia por pseudoartrose de clavícula: apresentação na quinta década de vida

et al. 2018

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Compression of the subclavian artery in the thoracic outlet is a well-known phenomenon. In rare cases, bone abnormalities, such as pseudarthrosis of the clavicle, can cause arterial compression at this level. Pseudarthrosis may develop as a result of trauma, which is the more common form, or it may be congenital. Here, the authors describe the case of a 44-year-old patient with critical ischemia of the right upper limb. She had a history of untreated right clavicle fracture at 9 months of age which had progressed to pseudarthrosis and extrinsic compression of the subclavian artery causing occlusion. The segment of the clavicle involved was resected and late thromboembolectomy of the subclavian, brachial, distal arteries was performed, with good results.Keywords: subclavian artery; thoracic outlet syndrome; critical ischemia. ResumoA compressão da artéria subclávia no desfiladeiro torácico é um fenômeno amplamente conhecido. Anormalidades ósseas, como a pseudoartrose da clavícula, podem raramente causar compressão arterial a esse nível. A pseudoartrose pode desenvolver-se em decorrência de um trauma, que é a forma mais comum, ou ser congênita. Os autores descrevem o caso de uma paciente de 44 anos com quadro de isquemia crítica de membro superior direito. Apresentava história de fratura não tratada de clavícula direita aos 9 meses de idade que evoluiu com pseudoartrose e compressão extrínseca com oclusão da artéria subclávia. O segmento da clavicula acometido pela pseudoartrose foi ressecado e realizada uma tromboembolectomia tardia das artérias subclávia, braquial e distais, com boa evolução.Palavras-chave: artéria subclávia; síndrome do desfiladeiro torácico; isquemia crítica.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: 11mentioning

confidence: 99%

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Compressão da artéria subclávia por pseudoartrose de clavícula: apresentação na quinta década de vida

et al. 2018

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“…The etiology of TOS is multiple. Potential causes of TOS are a cervical rib, abnormal ligamentous tissue, and hypertrophy of the scalenus anterior muscle [1,2].…”

Section: Introductionmentioning

confidence: 99%

Thoracic Outlet Syndrome Caused by a Pseudoaneurysm After Pseudarthrosis of the Clavicle

Heyn

Ozimek

Sadeghi‐Azandaryani

et al. 2008

Eur J Trauma Emerg Surg

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Clavicle fractures are common, with the majority treated conservatively. If treated conservatively, pseudarthrosis of the clavicle is reported in up to 3% of the cases. In rare cases, pseudarthrosis of the clavicle may cause pseudoaneurysm formation, resulting in compression of the brachial plexus and the adjoining vessels, which may produce neurological symptoms and circulatory disorders. Here, we describe two cases of the late onset of pseudoaneurysm formation after pseudarthrosis of the clavicle. Both cases were remarkable because they showed clinical symptoms of TOS. Therefore, surgical treatment was performed and included claviculectomy, resection of the pseudoaneurysm and interposition grafting with an artificial prosthesis. One year after the operation, both patients showed excellent upper extremity function without any deficit of vascular, sensorial or motorial function. Patient's history and radiological findings are the keys to diagnosis. Without treatment, the prognosis is poor with spontaneous development of bleeding or gangrene. Therefore, surgical treatment has to be performed, especially when neurological symptoms occur.

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