Thoracic outlet syndrome is the causative factor in less than 5% of patients with upper extremity ischemia. Congenital bony abnormalities (cervical rib) are most often responsible for the arterial complications of this syndrome. This article presents the case report of a patient who presented with ischemia of an upper extremity caused by embolization from subclavian artery stenosis and an aneurysm secondary to cervical rib. The treatment plan included excision of the cervical rib, repair of the subclavian artery aneurysm and a bypass graft which achieved a satisfactory outcome.
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