Claviculectomy for subclavian artery exposure

Claviculectomy is an alternate method for exposing the distal subclavian artery, permitting direct repair of complex injuries of the subclavian artery and veins. The incision is made directly over the clavicle and carried down to the periostium using electrocautery. The periosteum is divided longitudinally along the axis of the clavicle. A Gigle saw or equivalent is used to transect the clavicle medially and laterally, which may be more expedient and less morbid than attempting to remove the entire clavicle at the sternum. The underlying scalenus anticus muscle is identified and divided as it inserts on the first rib. The subclavian artery should then be easily exposed and controlled.