The importance of costoclavicular space on possible compression of the subclavian artery in the thoracic outlet region: a radio-anatomical study
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[Belirlenecek]Date
2018-03-07Author
Kaplan, TevfikCömert, Ayhan
Ataç, Gökçe Kaan
Esmer, Ali Fırat
Acar, Halil İbrahim
Özkurt, Bülent
Tekdemir, İbrahim
Han, Serdar
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OBJECTIVES: The purposes of this study were to identify possible compression points along the transit route of the subclavian artery and
to provide a detailed anatomical analysis of areas that are involved in the surgical management of the thoracic outlet syndrome (TOS). The
results of the current study are based on measurements from cadavers, computed tomography (CT) scans and dry adult first ribs.
METHODS: The width and length of the interscalene space and the width of the costoclavicular passage were measured on 18 cervical dissections
in 9 cadavers, on 50 dry first ribs and on CT angiography sections from 15 patients whose conditions were not related to TOS.
RESULTS: The average width and length of the interscalene space in cadavers were 15.28 ± 1.94mm and 15.98 ± 2.13 mm, respectively. The
widths of the costoclavicular passage (12.42 ± 1.43mm) were significantly narrower than the widths and lengths of the interscalene space in
cadavers (P < 0.05). The average width and length of the interscalene space (groove for the subclavian artery) in 50 dry ribs were 15.53 ± 2.12mm
and 16.12 ± 1.95mm, respectively. In CT images, the widths of the costoclavicular passage were also significantly narrower than those of the
interscalene space (P < 0.05). The measurements from cadavers, dry first ribs and CT images were not significantly different (P > 0.05).
CONCLUSIONS: Our results showed that the costoclavicular width was the narrowest space along the passage route of the subclavian
artery. When considering the surgical decompression of the subclavian artery for TOS, this narrowest area should always be kept in mind.
Since measurements from CT images and cadavers were significantly similar, CT measurements may be used to evaluate the thoracic outlet
region in patients with TOS.