A new surgical approach to the innominate and subclavian vein
| Autor: | Molina Je |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Thoracic outlet
Adult medicine.medical_specialty Sternum Adolescent Decompression Sternoclavicular joint Aorta Thoracic Constriction Pathologic Subclavian Vein Ischemia medicine Humans Transplantation Homologous Saphenous Vein Vein Brachiocephalic Veins Rib cage business.industry Thrombosis Middle Aged Decompression Surgical Fibrosis Surgery Transplantation medicine.anatomical_structure surgical procedures operative Treatment Outcome Thoracotomy Chronic Disease cardiovascular system business Cardiology and Cardiovascular Medicine Subclavian vein Follow-Up Studies |
| Zdroj: | Journal of Vascular Surgery. 27(3):576-581 |
| ISSN: | 0741-5214 |
| DOI: | 10.1016/s0741-5214(98)70337-4 |
| Popis: | A new technique extending the incision used for thoracic outlet decompression with a subclavicular approach to the first rib is presented. After the first rib and scalenotomy are removed, the subclavicular incision is continued into the sternum medially and superiorly to the sternal notch. This gives easy access to the innominate-subclavian-axillary vein segment. Eight patients with extensive chronic fibrotic obstruction of the subclavian-innominate vein segment underwent operation with this technique. It allows placement of either long patches of saphenous vein to reestablish normal caliber or replacement, as is our choice, with a small-sized cryopreserved descending thoracic aortic homograft. The operation is carried out in an extrapleural plane preserving the sternoclavicular joint, avoiding the deformity caused by transclavicular techniques. Repair of the sternotomy creates a stable incision. Follow-up to 14 months shows patency of the venous channel with no complications. This surgical approach is recommended to solve the problem of satisfactory exposure of the subclavian-innominate venous channel after decompression of the thoracic outlet. (J Vasc Surg 1998;27:576-81.) |
| Databáze: | OpenAIRE |
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