Reconstruction of a resected subclavian vein by transposition of the ipsilateral internal jugular vein

Abstract

FIGURE 1. Cervical computed tomographic scan showing a left encapsulated hypodense mass of 3 cm in diameter, localized between the left clavicle and the first rib and compressing the middle portion of the subclavian vein. IJV, Internal jugular vein; SV, subclavian vein; Tu, tumor mass; Cl, clavicle; 1st, first rib. A heterogeneous group of solid benign and malignant tumors may involve the thoracic inlet. Their surgical management requires complete en bloc resection, sometimes involving major adjacent structures. Generally, the vein is the first invaded element and debate still exists concerning the optimal management. Indeed, owing to the rich collateral circulation, most authors advocate simple ligation after removal of the invaded segment. Nevertheless, it is sometimes recommended to perform reconstruction owing to the risks of venous hypertension. Herein, we report an interesting reconstruction after subclavian vein resection. A young woman with a thoracic inlet sarcoma invading the left subclavian vein benefited from a superior thoracic wall en bloc resection, with removal of the vein. Venous continuity was restored by transposing the ipsilateral internal jugular vein to the axillary vein.