2022 Volume 31 Issue 3 Pages 151-155
A 51-year-old man had suffered from numbness and pain in the right arm. These symptoms were diagnosed with thoracic outlet syndrome by an orthopedist and had been observed without any treatment for 6 years. When the symptoms exacerbated and occluded subclavian artery was detected, he was referred to our hospital. Physical examination revealed different blood pressure in bilateral upper arms, muscle weakness in the right arm, limited range of motion in the right shoulder joint and positive Roos and Morley test. CT scan showed occluded right subclavian artery 8 cm in length, anomalous first rib and no cervical rib. These symptoms were caused by arterial thoracic outlet syndrome due to anomalous first rib. Resection of right anterior and middle scalene muscle, anomalous right first rib, thromboendarterectomy and autologous vein graft interposition of right subclavian artery were performed. Bothered symptoms improved postoperatively. Arterial thoracic outlet syndrome with arterial occlusion is relatively rare. Bone and muscle resection, arterial reconstruction was effective in this case.
