A 38 year old woman complained of sensory loss in her left arm 4 years after clavicular osteosynthesis. Pre-operative MRA (arm elevated) indicated metal induced susceptibility artifact (MISA) of the most medial screw compressing the subclavian artery (SA) with embolic occlusion of the brachial artery (BA). Thrombectomy was successfully performed via a cubital approach. A precautionary transfemoral angiogram was undertaken just prior to screw removal in case a stent graft would be required and showed appositional thrombus (T) corresponding to the most lateral screw (arm in adduction). Length, direction, and duration of the screws in situ were crucial for the development of the ischaemia.
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Publication history
Published online: March 31, 2017
Accepted:
March 3,
2017
Received:
December 12,
2016
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© 2017 European Society for Vascular Surgery. Published by Elsevier Ltd.
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