A 29-year-old woman came to us with pain and numbness in her hand that had been referred by a neurologist. On further tests, we found a rare condition where an extra rib was pressing on her blood vessels, causing a blockage and swelling. A detailed vascular assessment revealed a thrombosed brachial artery and aneurysmal dilatation of the right subclavian artery due to a cervical rib.
Diagnosis revealed that she was suffering from a rare and potentially limb-threatening condition Arterial Thoracic Outlet Syndrome (ATOS) with a subclavian aneurysm and distal embolization. She underwent a complex surgical procedure including cervical rib excision, subclavian artery reconstruction, and brachial artery thromboembolectomy. With timely intervention, we were able to restore blood flow and prevent serious complications, including limb loss. Post-surgery, the patient showed dramatic improvement with full restoration of hand perfusion and resolution of neurological symptoms. The case underscores the importance of multidisciplinary expertise and advanced imaging in diagnosing rare vascular disorders.
Dr. Krishna Chaitanya, Lead Consultant – Vascular & Endovascular Surgery, Aster CMI Hospital, said: “This case is a powerful reminder that not all limb pain is neurological or musculoskeletal. Vascular conditions like Arterial Thoracic Outlet Syndrome, though rare, can be limb-threatening if not identified early. Through a precise diagnosis and a tailored surgical approach, we were able to restore blood flow and ensure the patient made a full recovery.
Dr. Pavan B K, Senior Specialist – Vascular and Endovascular Surgery, Aster CMI Hospital, said: “Although many people have extra ribs in the neck, a few of them can cause pressure upon vital structures like arteries and veins. It is essential for all those with cervical ribs to check at least once if they have any arterial compression.”
SGS Lakshmanan, Chief Operating Officer of Aster CMI Hospital, added:
“This case reflects our commitment to delivering advanced and timely care across specialties. At Aster CMI, we are equipped to handle rare and complex conditions with a multidisciplinary approach. Our goal is to ensure that every patient receives the right diagnosis and the best possible outcome, no matter how challenging the case may be.
