{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:05:21Z","timestamp":1756339521792,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,2,10]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>Arterial thoracic outlet syndrome is relatively rare and often exclusively seen in the presence of bony anomalies. High-altitude (HA) travel is commonly associated with thrombosis; however, arterial thromboembolism is less frequently described. We describe a case of a young man with undiagnosed bilateral cervical rib, who went for an HA trek, subsequent to which developed acute limb ischaemia of right arm. Diagnostic workup revealed a subclavian artery aneurysm as well along with complete bony bilateral cervical ribs. Thoracic outlet syndrome should be kept as a differential diagnosis in a case of acute limb ischaemia in a healthy adult.<\/jats:p>","DOI":"10.1136\/bcr-2020-241194","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T11:08:20Z","timestamp":1614337700000},"page":"e241194","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Undiagnosed bilateral complete cervical rib with subclavian artery aneurysm presenting as acute ischaemic limb following high-altitude expedition"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2703-1128","authenticated-orcid":false,"given":"Raja","family":"Lahiri","sequence":"first","affiliation":[{"name":"CVTS, AIIMS Rishikesh, Rishikesh, Uttarakhand, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Udit","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Intervention Radiology, AIIMS Rishikesh, Rishikesh, Uttarakhand, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay","family":"Kumar","sequence":"additional","affiliation":[{"name":"Cardiac Anaesthesia, AIIMS Rishikesh, Rishikesh, Uttarakhand, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nisanth","family":"Puliyath","sequence":"additional","affiliation":[{"name":"General Surgery, AIIMS Rishikesh, Rishikesh, Uttarakhand, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,2,26]]},"reference":[{"key":"2025082708495718000_14.2.e241194.1","doi-asserted-by":"publisher","DOI":"10.1089\/ham.2007.1028"},{"key":"2025082708495718000_14.2.e241194.2","first-page":"40","article-title":"Arterial embolectomies in the upper extremity after acute occlusion. Report on 79 cases","volume":"24","author":"Wirsing","year":"1983","journal-title":"J Cardiovasc Surg"},{"key":"2025082708495718000_14.2.e241194.3","first-page":"63","article-title":"Exposure to high altitude: a risk factor for spontaneous radial artery thrombosis","volume":"9","author":"Kukreja","year":"2020","journal-title":"Paripex-Indian Journal of Research"},{"key":"2025082708495718000_14.2.e241194.4","first-page":"197","article-title":"Thrombosis as a complication of extended stay at high altitude","volume":"14","author":"Anand","year":"2001","journal-title":"Natl Med J India"},{"key":"2025082708495718000_14.2.e241194.5","unstructured":"Osgood MJ , Lum YW . Chapter 120: Thoracic Outlet Syndrome: Pathophysiology and Diagnostic Evaluation. In: Sidawy AN , Perler BA , eds. Rutherford\u2019s Vascular Surgery and Endovascular Therapy. 9th Edition. Elsevier, 2019: 1607\u201318."},{"key":"2025082708495718000_14.2.e241194.6","first-page":"593","article-title":"Prevalence of \u2018Cervical Rib\u2019 and its association with gender, body side, handedness and other thoracic bony anomalies in a population of Central India","volume":"3","author":"Sharma","year":"2014","journal-title":"Indian Journal of Basic and Applied Medical Research"},{"key":"2025082708495718000_14.2.e241194.7","unstructured":"Donahue DM , Osho A . Chapter 46: Thoracic Outlet Syndrome. In: Locicero J , Feins RH , Yolonda C , et al , eds. Shields\u2019 General Thoracic Surgery. 8th edn. Wolters Kluwer, 2019: 1299\u2013317."},{"key":"2025082708495718000_14.2.e241194.8","doi-asserted-by":"crossref","DOI":"10.1155\/2016\/8034613","article-title":"The epidemiological, morphological, and clinical aspects of the cervical ribs in humans","volume":"2016","author":"Spadli\u0144ski","year":"2016","journal-title":"Biomed Res Int"},{"key":"2025082708495718000_14.2.e241194.9","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1097\/NRL.0b013e31826754a9","article-title":"Cervical rib, a rare cause of recurrent stroke in the young: case report","volume":"18","author":"Kataria","year":"2012","journal-title":"Neurologist"},{"key":"2025082708495718000_14.2.e241194.10","unstructured":"Boll JM , Valentine RJ . Chapter 122: Thoracic Outlet Syndrome: Arterial. In: Sidawy AN , Perler BA , eds. Rutherford\u2019s Vascular Surgery and Endovascular Therapy. 9th edn. Elsevier, 2019: 1639\u201347."},{"key":"2025082708495718000_14.2.e241194.11","first-page":"664","article-title":"Staging of arterial complications of cervical rib: guidelines for surgical management","volume":"95","author":"Scher","year":"1984","journal-title":"Surgery"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-241194","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:50:06Z","timestamp":1756309806000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-241194"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2]]},"references-count":11,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2,26]]},"published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1136\/bcr-2020-241194"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-241194","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,2]]}}}