Transpleural resection of the first rib for repair of subclavian artery injury.

A technique is described for obtaining exposure of all three parts of the injured subclavian artery through a standard posterolateral thoracotomy and transpleural subperiosteal excision of the first rib. This technique should be considered for repairing injuries of the subclavian artery, especially when the injury is discovered at emergency thoracotomy done because of bleeding.