Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.009617
Jornal Vascular Brasileiro
Case Report

Compressão da artéria subclávia por pseudoartrose de clavícula: apresentação na quinta década de vida

Late presentation of critical upper limb ischemia caused by pseudarthrosis of the clavicle

Marcio Miyamotto, Lucas Vasconcelos Sanvido, Luan Facttore Brendolan, Amilton Cezar, Giana Caroline Strack Neves, Izara Castro de Souza, Ricardo César Rocha Moreira

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Resumo

A compressão da artéria subclávia no desfiladeiro torácico é um fenômeno amplamente conhecido. Anormalidades ósseas, como a pseudoartrose da clavícula, podem raramente causar compressão arterial a esse nível. A pseudoartrose pode desenvolver-se em decorrência de um trauma, que é a forma mais comum, ou ser congênita. Os autores descrevem o caso de uma paciente de 44 anos com quadro de isquemia crítica de membro superior direito. Apresentava história de fratura não tratada de clavícula direita aos 9 meses de idade que evoluiu com pseudoartrose e compressão extrínseca com oclusão da artéria subclávia. O segmento da clavicula acometido pela pseudoartrose foi ressecado e realizada uma tromboembolectomia tardia das artérias subclávia, braquial e distais, com boa evolução.

Palavras-chave

artéria subclávia; síndrome do desfiladeiro torácico; isquemia crítica.

Abstract

Compression of the subclavian artery in the thoracic outlet is a well-known phenomenon. In rare cases, bone abnormalities, such as pseudarthrosis of the clavicle, can cause arterial compression at this level. Pseudarthrosis may develop as a result of trauma, which is the more common form, or it may be congenital. Here, the authors describe the case of a 44-year-old patient with critical ischemia of the right upper limb. She had a history of untreated right clavicle fracture at 9 months of age which had progressed to pseudarthrosis and extrinsic compression of the subclavian artery causing occlusion. The segment of the clavicle involved was resected and late thromboembolectomy of the subclavian, brachial, distal arteries was performed, with good results.

Keywords

subclavian artery; thoracic outlet syndrome; critical ischemia.

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