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Updated: May 11, 2025

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
Published on: September 13, 2020
The Interscapular Lift: Unfolding the Tortuous Subclavian Artery
Chase J Ellingson1, Jyotpal Singh2, Neha Mehta2
1Prairie Vascular Research Inc, Regina, Saskatchewan, Canada; College of Medicine, University of Saskatchewan, Regina, Saskatchewan, Canada.
Objective:
Transradial cardiac catheterization has gained popularity because of its reduced risk of access-site complications, yet procedural failures remain frequent, often caused by subclavian artery tortuosity. We propose an alternative maneuver to improve procedural success rates, addressing the challenge of subclavian artery tortuosity more efficiently than existing time-consuming and resource-intensive techniques.
Key Steps:
Place a towel between the patient's scapulae to retract the shoulders before advancing the catheter.
Potential Pitfalls:
Aside from the increased time taken to place the towel and patient discomfort, no pitfalls are anticipated when attempting this maneuver.
Take-Home Messages:
In cases of severe subclavian artery tortuosity, positioning the patient supine with a towel between the scapulae can facilitate successful transradial cardiac catheterization.
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