A Case of Thrombectomy Performed by Supuraclavicular Incision for the Patient with Right Subclavian Artery Thromboembolism

Abstract

Thrombectomy for acute arterial obstruction of the upper limb is a useful method, but it can sometimes cause serious complications of vertebral artery embolism. A 52-year-old man was referred to our department for coldness and numbness of the right upper limb for three days. Contrast enhanced computed tomography revealed thrombosis of the right subclavian artery and a thrombus in the ascending aorta and the aortic arch. The thrombus in the right subclavian artery was located just distal to the right vertebral artery branch. To prevent right vertebral artery thromboembolism, we performed thrombectomy via the right subclavian artery through the supraclavicular incision. Since the vertebral artery can be dissected by supraclavicular incision, cerebral infarction due to vertebral artery embolism can be prevented by clamping the vertebral artery during thrombectomy. Postoperative course was uneventful. We advocate thrombectomy by supraclavicular incision for acute arterial obstruction of the upper limb that is considered to be at risk of the vertebral artery embolism in surgical procedure.