Anatomy:
3 parts
1st: origin to scalenus anterior
2nd: medial SA to clavicle
3rd: clavicle to medial pec minor
Area of SC artery to be exposed:
Proximal left: left lateral thoracotomy and supraclavicular incision or trapdoor
Proximal right (first portion): median sternotomy with right cervical extension
Second portion either side: Supraclavicular incision with infraclavicular extension (s shaped incision)
Right or left third portion: as above
clavicle may need to be disarticulated
If stable: perform trapdoor/left lateral thoracotomy
If unstable: left anterolateral thoracotomy, apply pressure apex pleural cavity, clamp origin
repair primary anastomosis or interposition graft
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