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Arterial embolism from anatomical variation at the thoracic outlet
Author(s) -
Dovgan Peter S.,
Edwards John D.,
Ayoub Magi T.,
Horpe Patricia T,
Agrawal Devendra K.
Publication year - 1995
Publication title -
clinical anatomy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.667
H-Index - 71
eISSN - 1098-2353
pISSN - 0897-3806
DOI - 10.1002/ca.980080308
Subject(s) - medicine , thoracic outlet syndrome , subclavian artery , anatomy , brachial plexus , rib cage , cervical rib , thorax (insect anatomy) , neurovascular bundle , surgery
Abstract Thoracic outlet syndrome (TOS) represents a constellation of symptoms arising from the compression of the neurovascular bundle as it exits the thorax. We report a unique case of multiple rare anatomical anomalies resulting in TOS manifested by distal arterial embolism. These anomalies include the combination of: (1) a unilateral right cervical rib, Gruber's type II (Gruber 1869), (2) nonunion of the first thoracic rib, (3) abnormal fibrous insertions of the anterior scalene muscle onto the epineurium of the brachial plexus and adventitia of the subclavian artery, (4) anterior position of the brachial plexus in relation to the third portion of the subclavian artery, and (5) the bifurcation of a single root of the phrenic nerve at the level of the anterior scalene muscle. This series of findings suggest an underlying developmental abnormality with a delayed onset of symptomatology consisting of the thoracic outlet syndrome. © 1995 WiIey‐Liss, Inc.