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. 2024 May 6;54(9):1015–1021. doi: 10.1007/s00595-024-02838-6

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© The Author(s) 2024

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 3 — Surgical view of the hemiclamshell approach only. A Surgical view of the hemiclamshell approach plus the transmanubrial osteomuscular sparing approach. The anterior compartment can be seen. Yellow arrow head; Left common arotid artery, White arrow head; phrenic nerve, White line; main tumor. B Access to the subclavian artery was enabled. Yellow arrow head; Left common carotid artery, Blue arrow head; subclavian artery. C View of the reconstruction of the subclavian artery. Blue arrow head; subclavian artery, White arrow head; phrenic nerve. HCS hemiclamshell, TMA transmanubrial osteomuscular sparing approach, SCA subclavian artery, CCA common carotid artery, VA vertebral artery