case_images: PMC11086424_01
case_images: PMC11086424_02
case_images: Severe bilateral costochondral fractures with lung herniation, represented by asterisks.
case_images: tsaco-2024-001426f01.jpg
case_images: PMC11086424_02_tsaco-2024-001426f01.jpg
case_images: F1
case_images: On exposure of the anterior chest wall, it was noted that bilateral lung parenchyma had herniated through the disrupted costochondral fractures (figure 1).
case_images: PMC11086424_03
case_images: Intraoperative venogram (A) pre-stent deployment with arrow indicating small area of blush; (B) successful deployment of subclavian vein stent; (C) flow through patent stent without extravasation of contrast.
case_images: tsaco-2024-001426f02.jpg
case_images: PMC11086424_03_tsaco-2024-001426f02.jpg
case_images: F2
case_images: Repeat venography was performed with the lung retracted, which showed an area of concern at the junction of the left internal jugular and subclavian vein (figure 2A). Repeat venography demonstrated good positioning (figure 2B) with adequate patency and without extravasation of contrast (figure 2C).
case_images: PMC11086424_04
case_images: Chest wall reconstruction.
case_images: tsaco-2024-001426f03.jpg
case_images: PMC11086424_04_tsaco-2024-001426f03.jpg
case_images: F3
case_images: The chest wall was reconstructed over the Vicryl mesh utilizing a combination of polyether ether ketone (PEEK) plates (PEEK, KLS Martin, Jacksonville, FL) and a titanium plating system (T-plate, KLS Martin, Jacksonville, FL) (figure 3).