Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.200193
Jornal Vascular Brasileiro
Therapeutic Challenge

Tratamento de oclusão arterial em membro superior causada por costela cervical

Treatment of upper limb arterial occlusion caused by a cervical rib

Vanessa Aline Miranda Vieira Milagres; Roberto Lucas de Sena Avellar; Ana Paula Pires Silva; Pedro José Pires Neto; Daniel Mendes Pinto

Downloads: 0
Views: 153

Resumo

Resumo: A síndrome da costela cervical ocorre quando o triângulo intercostoescalênico é ocupado por uma costela cervical, deslocando o plexo braquial e a artéria subclávia anteriormente, o que pode gerar dor e espasmo muscular. O objetivo deste estudo é discutir sobre o diagnóstico da síndrome da costela cervical e as possibilidades de tratamento. Este desafio terapêutico descreve a condução clínica e cirúrgica de uma paciente de 37 anos com obstrução arterial em membro superior causada por costela cervical.

Palavras-chave

costela cervical, síndrome do desfiladeiro torácico, artéria subclávia, veia subclávia, plexo braquial

Abstract

The cervical rib syndrome occurs when the interscalene triangle is occupied by a cervical rib, displacing the brachial plexus and the subclavian artery forward, which can cause pain and muscle spasms. The objective of this study is to discuss diagnosis of the cervical rib syndrome and treatment possibilities. This therapeutic challenge describes clinical and surgical management of a 37-year-old female patient with upper limb arterial occlusion caused by a cervical rib.

Keywords

cervical rib; thoracic outlet syndrome; subclavian artery; subclavian vein; brachial plexus.

References

1 Ciorlin E, Araújo JD, Araújo JD Fo. Síndromes compressivas neurovasculares cervicotoracoaxilares (Síndrome do desfiladeiro). In: Brito CJ, Silva RM, Araújo, EL. Cirurgia vascular: cirurgia endovascular, angiologia. 4. ed. Rio de Janeiro: Thieme Revinter Publicações; 2020. p. 733-747.

2 Henry BM, Vikse J, Sanna B, et al. Cervical rib prevalence and its association with thoracic outlet syndrome: a meta-analysis of 141 studies with surgical considerations. World Neurosurg. 2018;110:e965-78. http://dx.doi.org/10.1016/j.wneu.2017.11.148. PMid:29203316.

3 Daniels B, Michaud L, Sease F Jr, Cassas KJ, Gray BH. Arterial thoracic outlet syndrome. Curr Sports Med Rep. 2014;13(2):75-80. http://dx.doi.org/10.1249/JSR.0000000000000034. PMid:24614419.

4 Jayaraj A, Duncan AA, Kalra M, Bower TC, Gloviczki P. Outcomes of transaxillary approach to cervical and first-rib resection for neurogenic thoracic outlet syndrome. Ann Vasc Surg. 2018;51:147-9. http://dx.doi.org/10.1016/j.avsg.2018.02.029. PMid:29772332.

5 Wybaillie E, Maene L, Cooreman F, Beelen R. Robotically assisted transthoracic cervical rib resection. Ann Thorac Surg. 2018;106(5):e253-5. http://dx.doi.org/10.1016/j.athoracsur.2018.04.016. PMid:29752917.

6 Chan YC, Gelabert HA. Hight-definition video-assisted transaxillary first rib resection for thoracic outlet syndrome. J Vasc Surg. 2013;57(4):1155-8. http://dx.doi.org/10.1016/j.jvs.2012.10.089. PMid:23357519.

7 Gelabert HA, Rigberg DA, O’Connell JB, Jabori S, Jimenez JC, Farley S. Transaxillary decompression of thoracic outlet syndrome patients presenting with cervical ribs. J Vasc Surg. 2018;68(4):1143-9. http://dx.doi.org/10.1016/j.jvs.2018.01.057. PMid:29705086.

8 Fairman AS, Fairman RM, Foley PJ, Etkin Y, Jackson OA, Jackson BM. Is routine postoperative anticoagulation necessary in all patients after first rib resection for paget-schroetter syndrome? Ann Vasc Surg. 2020;69:217-23. http://dx.doi.org/10.1016/j.avsg.2020.05.042. PMid:32497616.

9 Gelabert HA, Jimenez JC, Davis GR, Derubertis BG, O’Connell JB, Rigberg DA. Early postoperative hemorrhage after first rib resection for vascular thoracic outlet syndrome. Ann Vasc Surg. 2011;25(5):624-9. http://dx.doi.org/10.1016/j.avsg.2011.02.023. PMid:21724102.

10 Morel J, Pirvu A, Elie A, Gallet N, Magne JL, Spear R. Functional results of cervical rib resection for thoracic outlet syndrome: impact on professional activity. Ann Vasc Surg. 2019;56:233-9. http://dx.doi.org/10.1016/j.avsg.2018.09.007. PMid:30476612.
 


Submitted date:
09/08/2020

Accepted date:
03/08/2021

60c9eb0ea95395390f5d0b92 jvb Articles

J Vasc Bras

Share this page
Page Sections