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Subclavian Artery



- See:
      - arteries of the upper limb
      - subclavian vein
      - thoracic outlet syndrome;

- Discussion:
    - injuries are rare because of overlying bony skeleton;
    - right subclavian artery originates from innominate artery & passes into neck behind the right SC joint;
    - left subclavian artery comes off aortic arch and enters neck behind left sternoclavicular joint;
    - as it traverses the base of the neck, it lies between the anterior scalene and the scalene medius muscle;
    - subclavian artery is divided into three parts by its relation to scalenus anticus muscle;
    - at lateral border of first rib the subclavian artery continues as axillary artery;
    - frxs of first rib or clavicle may cause injury to subclavian vessel, but this is rare;
    - assoc neurological injuries frequently cause permanent disability;
    - when neurologic deficit is caused by compression of brachial plexus by hematoma rather than by direct injury, early evacuation of hematoma may result in significant functional improvement;
    - there are a few small series of patients with subclavian injuries w/ neurologic deficits:
    - prompt exploratory surgery even in absence of distal ischemia, w/ goal of relieving compression on brachial plexus by hematoma;
            - pts will improve if there is not direct injury to brachial plexus;
    - ligation of the subclavian artery is usually well tolerated because of execellent collateral circulation around the shoulder girdle;

- Subclavian Artery Aneurysms:
    - usually do to atherosclerosis, but may be due to trauma;
    - if thrombosis is present, there may be emboli to hands;
    - these may be either intrathoracic or supraclavicular (pulsating mass)
    - usually is seen on the right side;
    - most of these aneurysms contain mural thrombi



An Experience with Upper-Extremity Vascular Trauma.

Year Book: Management of Arm Arterial Injuries.

Evaluation of patients with thoracic outlet syndrome.

Arterial abnormalities of the shoulder in athletes.