PMID: 9546249Apr 18, 1998Paper

A new surgical approach to the innominate and subclavian vein

Journal of Vascular Surgery
J Ernesto Molina

Abstract

A new technique extending the incision used for thoracic outlet decompression with a subclavicular approach to the first rib is presented. After the first rib and scalenotomy are removed, the subclavicular incision is continued into the sternum medially and superiorly to the sternal notch. This gives easy access to the innominate-subclavian-axillary vein segment. Eight patients with extensive chronic fibrotic obstruction of the subclavian-innominate vein segment underwent operation with this technique. It allows placement of either long patches of saphenous vein to reestablish normal caliber or replacement, as is our choice, with a small-sized cryopreserved descending thoracic aortic homograft. The operation is carried out in an extrapleural plane preserving the sternoclavicular joint, avoiding the deformity caused by transclavicular techniques. Repair of the sternotomy creates a stable incision. Follow-up to 14 months shows patency of the venous channel with no complications. This surgical approach is recommended to solve the problem of satisfactory exposure of the subclavian-innominate venous channel after decompression of the thoracic outlet.

References

Nov 1, 1976·The Annals of Thoracic Surgery·D B Doty, W H Baker
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Citations

Mar 1, 2011·The Annals of Thoracic Surgery·Phillip S GeTimothy L Van Natta
Sep 22, 2007·Seminars in Vascular Surgery·Sanford D Altman
Oct 25, 2002·Journal of Vascular and Interventional Radiology : JVIR·Melhem J SharafuddinJamal J Hoballah
Dec 5, 2006·Journal of Vascular Nursing : Official Publication of the Society for Peripheral Vascular Nursing·Nancy D Shebel, Alice Marin
Jan 24, 2009·The Annals of Thoracic Surgery·J Ernesto MolinaCharles A Dietz
Mar 10, 2001·Journal of Vascular Surgery·J E Molina
Sep 22, 2001·The Annals of Thoracic Surgery·A Handa Frcs
May 10, 2015·International Journal of Surgery Case Reports·Juan A SiordiaSreekumar Subramanian
Aug 5, 2000·Journal of Vascular Surgery·R M GreenJ A Deweese
Oct 9, 2004·Journal of Vascular Surgery·Nikos KavallieratosPetros Kalocheretis
Jun 15, 2011·Journal of Vascular Surgery·Javier E Anaya-AyalaEric K Peden
Feb 1, 2007·Journal of Vascular Surgery·J Ernesto MolinaCharles A Dietz
Apr 15, 2015·Seminars in Vascular Surgery·Richard J Sanders, Stephen J Annest
May 28, 2016·Cardiovascular and Interventional Radiology·Jussi M KärkkäinenHannu Manninen
Sep 18, 2016·Journal of Vascular Surgery. Venous and Lymphatic Disorders·Chandu VemuriRobert W Thompson
Nov 2, 2011·British Journal of Hospital Medicine·Anthony S Ward, Manish Chand
May 12, 2020·Vascular and Endovascular Surgery·Jennifer DutmersJerry Matteo
Feb 2, 2018·Annals of the Royal College of Surgeons of England·G SamoilaI M Williams

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