c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Subclavian Steal Syndrome and Carotid-Subclavian Bypass: 10

A D V E R T I S E M E N T

   
 

The clavicular head of the sternocleidomastoid muscle was divided and the muscle was mobilized along its lateral border and retracted medially. The carotid sheath was identified under the muscle, and its contents exposed. The internal jugular vein was identified. The vagus nerve was identified posterior to the vein and carefully protected.      

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Subclavian Steal Syndrome and Carotid-Subclavian Bypass: 11

A D V E R T I S E M E N T

   
 

The scalene fat pad was identified and is seen here lateral to the surgeon's forceps. The fat pad was mobilized along its medial and inferior borders. During mobilization, the fat pad and its associated rich network of lymphatics were meticulously ligated to prevent lymph leak. Once mobilized, the fat pad was retracted posterolaterally to expose the anterior scalene muscle.      

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Subclavian Steal Syndrome and Carotid-Subclavian Bypass: 12

A D V E R T I S E M E N T

   
 

The anterior scalene muscle is seen lying deep to the retracted fat pad. The phrenic nerve is demonstrated on the ventral surface of the anterior scalene muscle, where it is usually found coursing near the muscle's medial border.       

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This page was last modified on 6/30/2000.