COSTOCLAVICULAR SYNDROME: MODERN PRINCIPLES OF CHOOSING A SURGICAL TREATMENT METHOD

Authors

N.R. Kurbanov1;2
Job:

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DOI:
10.65197/3106-4035-2026-2-1-23-45

Annotation

Resume.

Goal.

Optimization of selection criteria and improvement of surgical tactics for costoclavicular syndrome.

Material and methods.

The study included data from a comprehensive clinical and instrumental examination and surgical treatment of 110 patients with costoclavicular syndrome treated in the Vascular Surgery Department of the Republican Scientific Center for Cardiovascular Surgery from 2010 to 2021. The majority of patients were women—66 (60%); there were 44 men (40%). The age ranged from 16 to 63 years, with an average age of 27.6 ± 10.9 years.

Results.

Based on the clinical and instrumental examination, bilateral lesions were detected in 97 patients (88.2%), and unilateral lesions in 13 (11.8%). The distribution of the predominant manifestations was as follows: mixed form – 62 cases (56.4%); arterial – 22 (20%); neurological – 22 (20%); venous – 4 (3.6%). Secondary Raynaud’s phenomenon was diagnosed in 76 patients (69.1%). Developmental anomalies in the form of an additional cervical rib were detected in 4 patients, and a rudimentary rib – in 3.

In patients with the mixed form, neurological symptoms predominated at rest: dull aching pain in the shoulder girdle, upper arm, and precordial area, paresthesia, and sensory disturbances in the forearm and fingers. Symptoms worsened with raising and abducting the arm. Arterial disturbances manifested themselves during functional load, including shortterm loss of movement, especially after sleeping in a position with a limb raised or placed behind the head.

Conclusion.

Thus, the accumulated clinical experience allows us to formulate the following provisions. Transaxillary resection of the first rib, despite its technical complexity, is a pathogenetically justified and highly effective treatment method for mixed and neurological forms of costoclavicular syndrome, providing decompression of the neurovascular bundle at all three anatomical levels of the thoracic outlet.

For arterial variants of costoclavicular syndrome accompanied by secondary Raynaud’s phenomenon, scalenotomy in combination with selective cervicothoracic sympathectomy, arteriolysis, and neurolysis is advisable.

Keywords

Costoclavicular syndrome selective cervicothoracic sympathectomy neurovascular bundle vascular surgery.

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Information
Language

English

License

CC BY 4.0

Category

VASCULAR SURGERY

FINANCING

There was no financial support.

CONFLICT OF INTEREST

The author declare no conflict of interest.

INFORMATION ABOUT THE AUTHORS:

*Kurbanov Nuryagdy Rozmura- tovich – Candidate of Medical Sciences, Assistant Professor, Department of Sur- gical Diseases No. 2 named after Acade- mician N.U. Usmanov, State Educational Institution “Tajik State Medical Universi- ty named after Avicenna”, Researcher, De- partment of Vascular Surgery, Republican Scientific Center for Cardiovascular Sur- gery, Dushanbe, Tajikistan.

E-mail: kurbanovnr71@mail.ru

https://orcid.org/0000-0002-8277-1292

*Correspondence address.