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Subclavian Artery Stenosis / Aneurysm

 

synonyms: subclavian artery stenosis, subclavian artery aneurysm, subclavian artery occlusion

Subclavian Artery Stenosis / Aneurysm ICD-9

Subclavian Artery Stenosis / Aneurysm Etiology / Epidemiology / Natural History

  • Occurs secondary to compression of the subclavian artery at the level of the first rib, generally associated with a congenital cervical rib or aberrant first rib.

Subclavian Artery Stenosis / Aneurysm Anatomy

  • Associated with congenital cervical rib or aberrant first rib.

Subclavian Artery Stenosis / Aneurysm Clinical Evaluation

  • Generally asymptomatic until distal emboli develop.
  • Emboli cause occlusion of brachial, radial, ulnar, and/or digital arteries
  • Arterial occlusion leads to exertional arm fatigue and/or acute digital ischemia.

Subclavian Artery Stenosis / Aneurysm Xray / Diagnositc Tests

  • A/P and lateral c-spine films: evaluate for a cervical rib
  • Contrast-enhanced arteriography indicated to determine the extent, location, and character of arterial occlusions and to detect the presence of subclavian artery compression/aneurysm formation.
  • Consider upper extremity blood pressures, segmental pulse waveforms,

Subclavian Artery Stenosis / Aneurysm Classification / Treatment

  • Anticoagulation to limit extent of thrombus
  • Thromboembolectomy.
  • Subclavian artery aneurysms = supraclavicular thoracic outlet decompression with scalenectomy and removal of the cervical and first ribs, followed by excision of the aneurysm and interposition bypass graft reconstruction (prosthetic bypass grafts or saphenous vein, superficial femoral vein, or iliac artery).

Subclavian Artery Stenosis / Aneurysm Associated Injuries / Differential Diagnosis

Subclavian Artery Stenosis / Aneurysm Complications

  • Digital ischemia

Subclavian Artery Stenosis / Aneurysm Follow-up Care

Subclavian Artery Stenosis / Aneurysm Review References

 

 

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