INFRACLAVICULAR FIRST RIB RESECTION FOR DECOMPRESSION OF VENOUS THORACIC OUTLET SYNDROME

Mohammed Abdelhamid Elsabbagh; Mohamed El Sayed Salem; Monir Kamel Mabrouk; Ali Ahmed El-emam; Ahmed Gaweesh

Mohammed Abdelhamid Elsabbagh Alexandria University, faculty of medicine.
Mohamed El Sayed Salem Alexandria University, faculty of medicine.
Monir Kamel Mabrouk Alexandria University, faculty of medicine.
Ali Ahmed El-emam Alexandria University, faculty of medicine.
Ahmed Gaweesh Alexandria University, faculty of medicine.

Keywords: VTOS, McCleery syndrome, Pectoralis minor syndrome, 1st rib resection, Infraclavicular approach

Abstract

Background: McCleery syndrome is a form of venous thoracic outlet syndrome. This study aims to monitor the effectiveness of infraclavicular approach for decompression of venous thoracic outlet syndrome.

Methods: A prospective study at Alexandria University hospital where patients presented with intermittent upper limb venous symptoms due to venous thoracic outlet syndrome were included to study the outcome of interventions. Only patients who had decompression via the infraclavicular approach were included in this article, data regarding the intervention and its outcome was collected and analysed to calculate the frequencies.

Results: 15 patients (10 males) with mean age of 35 years (23 – 53 years) were recruited. All patients were diagnosed as McCleery syndrome. Eighty percent had right side presentation in the form of intermittent pain and swelling. Patients had first rib resection using the infra-clavicular approach with technical success of 100%. Complete resolution of symptoms was achieved in 100% of the study group after a secondary intervention. The symptoms resolution after the initial intervention was achieved in 93.3%. No perioperative complications were recorded. The mean follow-up duration was 8.6 months.

Conclusion: Infraclavicular approach for first rib resection in venous thoracic outlet syndrome is safe and effective in the short term.

Author Biographies

Mohamed El Sayed Salem, Alexandria University, faculty of medicine.

Professor of vascular surgery

Monir Kamel Mabrouk, Alexandria University, faculty of medicine.

Professor of vascular surgery.

Ali Ahmed El-emam, Alexandria University, faculty of medicine.

Professor of vascular surgery.

Ahmed Gaweesh, Alexandria University, faculty of medicine.

Lecturer of vascular surgery.