Book Chapter10.1007/978-3-030-55073-8_65
Surgical Techniques: Operative Decompression Using the Infraclavicular Approach for VTOS with Intraoperative Venography
Matthew C. Smith,Darren B. Schneider +1 more
- 01 Jan 2021
- pp 587-590
TL;DR: The infraclavicular approach as mentioned in this paper provides direct access to the costoclavicular space for focused treatment of VTOS using anterior first rib resection and subclavian venolysis.
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Abstract: The infraclavicular approach provides direct access to the costoclavicular space for focused treatment of VTOS. Using this approach anterior first rib resection and subclavian venolysis can be performed within the same procedure without unnecessary exposure or manipulation of the brachial plexus or subclavian artery. Additionally, sacrifice of collateral veins that usually exist in the supraclavicular and axillary areas is easily avoided. Finally, the infraclavicular approach provides excellent exposure for surgical reconstruction of the subclavian vein with either patch angioplasty or interposition bypass grafting if required. This approach offeres excellent technical and clinical results as have been reported by multiple groups.
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TL;DR: The surgical relief of the syndrome has largely conformed to Adson's original technique 1 intended for removal of the cervical rib, although other techniques have been described, namely, the posterior approach recommended by Clagett ~ and the axillary approach by Roos.
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Jeffrey J. Siracuse,Jeffrey J. Siracuse,Paul C. Johnston,Douglas W. Jones,Heather L. Gill,Peter H. Connolly,Andrew J. Meltzer,Darren B. Schneider +7 more
TL;DR: An infraclavicular approach to VTOS provides excellent access to the costoclavicular space for first rib resection and subclavian venolysis while at the same time minimizing the risk of brachial plexus and phrenic nerve injury.