Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2016 Aug 24;2(3):111-113.
doi: 10.1016/j.jvscit.2016.04.004. eCollection 2016 Sep.

First rib removal and decompression of the thoracic outlet as an indication to facilitate hemodialysis

Seamus M McHugh  1 , Mohamad A Hussain  1   2 , Badr Aljabri  1   3 , Elisa Greco  1   2   4 , Mohammed Al-Omran  1   2   3   4
Affiliations
Case Reports

First rib removal and decompression of the thoracic outlet as an indication to facilitate hemodialysis

Seamus M McHugh et al. J Vasc Surg Cases Innov Tech. .

Abstract

We present two cases of thoracic outlet decompression performed to facilitate hemodialysis through upper limb arteriovenous fistulas. In patients undergoing arteriovenous fistula formation for dialysis access, venous hypertension is a well-known complication. We used a supraclavicular approach in our two reported cases to remove the first rib to facilitate hemodialysis. Dialysis patients presenting with central venous stenosis should be assessed for evidence of extrinsic compression by the first rib as management options differ from those with central venous stenosis due to an intravenous catheter.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Fistulogram in a 59-year-old woman demonstrating significant right subclavian venous stenosis between the clavicle and first rib.
Fig 2
Fig 2
Venogram in a 42-year-old man demonstrating compression of the right subclavian vein between the clavicle and first rib.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Cooper A. In: Surgical essays. Cooper A., Travers B., editors. Longman; London: 1821. An exostosis; p. 128.
    1. Peet R.M., Henriksen J.D., Anderson T.P., Martin G.M. Thoracic-outlet syndrome: evaluation of a therapeutic exercise program. Proc Staff Meet Mayo Clin. 1956;31:281–287. - PubMed
    1. Huang J.H., Zager E.L. Thoracic outlet syndrome. Neurosurgery. 2004;55:897–902. - PubMed
    1. Pang D., Wessel H.B. Thoracic outlet syndrome. Neurosurgery. 1988;22:105–121. - PubMed
    1. Hussain MA, Aljabri B, Al-Omran M. Vascular thoracic outlet syndrome [published online October 28, 2015]. Semin Thorac Cardiovasc Surg 10.1053/j.semtcvs.2015.10.008. - DOI - PubMed

Publication types

LinkOut - more resources