Massive arm necrosis as a result of a subclavian artery occlusion after mastectomy and radiotherapy

A 60-year-old woman with a severe necrosis caused by a blunt trauma of her right upper arm is described. She had a history of ablation and radiotherapy of her right breast followed by a diagnosis of breast cancer 34 years previously. An angiogram revealed a complete occlusion of the right subclavian artery. After the reperfusion of the right arm, the necrosis at the upper arm was resected. After further operations, the wound could finally be closed with a skin graft. Today, the patient is able to complete all her activities of daily living. Despite a restriction in her range of motion, she complains about intermittent pain. Arterial occlusion of the ipsilateral limb is a rare event decades after mastectomy and radiation. A related necrosis in these dimensions and successful limb-saving treatment has not been previously described.