The supraclavicular approach to decompression of the thoracic outlet.

Surgical decompression of the thoracic outlet, along with treatment of the involved nerve or vessel, is the accepted treatment modality when indicated. Although neurogenic thoracic outlet syndrome (TOS) is often operated via the axillary approach and venous TOS via the paraclavicular approach, arterial TOS is almost always operated via the supraclavicular approach. The supraclavicular approach provides excellent access to the artery, brachial plexus, phrenic nerve, and the cervical and/or first ribs, along with any bony or fibrous or muscular abnormality that may be causing compression of the neurovascular structures.

De novo arteriovenous malformations in post-thrombotic limbs.

A 50-year-old woman presented with progressive, painful and disabling swelling of the left lower limb following a left ovarian cyst excision 2 years ago. She had gross oedema of the left lower limb with multiple pubic varices. Contrast-enhanced CT and digital subtraction imaging revealed diffuse arteriovenous malformation (AVM) with feeders from the left internal iliac artery and a short segment significant stenosis of the proximal left common iliac vein.

Progressive Arterial Insufficiency in a Displaced Salter-Harris Type 1 Distal Femoral Fracture: A Case Report.

Case: A 17-year-old male patient presented with Salter-Harris type I hyperextension injury of left distal femur with delayed development of acute limb ischemia secondary to popliteal artery injury.

Conclusion: Popliteal artery injury associated with distal femoral physeal fracture may not be clinically obvious at the time of initial presentation. When initial pulse examination and segmental Doppler measurements are normal, it is important to perform serial examination by experienced examiners because arterial insufficiency may develop over the subsequent 48 hours.