[Positional occlusion of the descending scapular artery in transverse thoraco-brachial syndrome with neurologic symptoms].

We report a thoracic outlet syndrome revealed by neurological complications. Angiography of the subclavian artery depicted an isolated positional occlusion of the descending scapular artery. This side branch of the subclavian artery is anatomically located close to and supplies the brachial plexus. Surgical treatment led to improvement of most symptoms and post-operative control angiography was normal. Not previously described, this sign illustrates the objective compression of the brachial plexus. Ischemia is perhaps intricated with compression, a well-known pathophysiological mechanism of neurological complications in this syndrome. This artery feeding the brachial plexus is usually ligated during surgical neurolysis but must be preserved in order to improve recovery of neurological function and prevent surgical failures.