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Related Experiment Videos

Vascular thoracic outlet syndrome.

Lazar B Davidovic1, Dusan M Kostic, Nenad S Jakovljevic

  • 1Institute for Cardiovascular Diseases, Serbian Clinical Centre, 8, K Todorovica St, 11 000, Belgrade, Yugoslavia. lazard@eunet.yu

World Journal of Surgery
|April 26, 2003
PubMed
Summary

Surgical treatment for vascular thoracic outlet syndrome (TOS) effectively resolves arterial TOS symptoms. Combined approaches provide comprehensive decompression, though venous TOS with thrombosis shows limited symptom relief.

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Area of Science:

  • Vascular Surgery
  • Thoracic Surgery
  • Symptomatology of TOS

Background:

  • Vascular thoracic outlet syndrome (TOS) is less common than neurogenic TOS but often requires surgical intervention.
  • Compression causes include cervical ribs, soft tissue anomalies, and post-fracture scar tissue, leading to arterial or venous complications.

Purpose of the Study:

  • To present the surgical treatment outcomes for vascular TOS.
  • To evaluate the efficacy of a combined supraclavicular and infraclavicular surgical approach.

Main Methods:

  • Surgical decompression via a combined supraclavicular and infraclavicular approach for 30 vascular TOS cases.
  • Procedures included rib excision, soft tissue release, aneurysm resection/replacement, bypass grafting, and brachial embolectomy.
  • Anticoagulant therapy was used for axillary-subclavian vein thrombosis.

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Main Results:

  • Complete symptom resolution and return to full activity in all arterial TOS cases.
  • Significant improvement in arterial TOS symptoms, including hand ischemia and TIA.
  • Partial symptom relief in venous TOS without thrombosis; limited improvement in venous TOS with thrombosis.
  • Arterial patency maintained post-reconstruction; minor complications included pleural and brachial plexus injuries.

Conclusions:

  • The combined surgical approach is effective for vascular TOS, particularly arterial forms.
  • Surgical decompression offers excellent outcomes for arterial TOS, while venous TOS with thrombosis has a less favorable prognosis.
  • Vascular TOS necessitates surgical management, with the combined approach offering optimal exposure and treatment efficacy.