SUBCLAVIAN ARTERY ANEURYSMS IN PATIENTS W ITH THORACIC OUTLET SYNDROMES

The true subclavian artery aneurysm is a rare but dangerous complicati on of TOS. During a 20 years time period we observed 18 patients with subclavian artery aneurysms, 12 of these patients showed cervical ribs . Half of the patients(n = 9) presented with a critical ischemia of an upper extremity, nine patients were operated on electively. The acute ischemia makes the desobliteration of the outflow tract necessary fir st. The next step ist the transaxillary exarticulation of the first ri b and the resection of the aneurysm. The reconstruction of the subclav ian artery is performed by using autologous vein material or PTFE pros theses, In two cases both with an acute embolic critical ischemia majo r amputations were unavoidable, 13 patients could be reexamined in 199 6: 11 bypasses proved to be functioning, 2 were definitely occluded.