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[Thoracic outlet syndrome: clinical staging].
Alessandro Busetto1, Paolo Fontana, Antonio Zaccaria
1U.O. di Chirurgia Toracica, Ospedale Civile Umberto I, Mestre, Venezia.
Chirurgia Italiana
|March 25, 2004
Summary
A new classification system for thoracic outlet syndrome (TOS) called NAV staging (nerve, artery, vein) helps group patients for consistent treatment. This system, based on clinical and instrumental findings, aims for universal acceptance in guiding TOS therapy.
Area of Science:
- Vascular Surgery
- Neurology
- Medical Classification Systems
Background:
- Thoracic outlet syndrome (TOS) presents with varied clinical and instrumental findings.
- Current therapeutic choices for TOS lack standardization, often differing based on physician experience.
- A unified, therapy-oriented classification is needed for TOS management.
Purpose of the Study:
- To develop a universally accepted, therapy-oriented staging system for TOS.
- To integrate clinical and instrumental findings into a single classification.
- To establish a staging system analogous to the TNM system for cancer.
Main Methods:
- A retrospective analysis of 156 patients with TOS evaluated between 1984 and 2002.
- Development of the nerve, artery, and vein (NAV) staging system based on injury status.
- Grouping patients into 4 stages according to their NAV status.
- Therapy was subsequently tailored to the determined stage.
Main Results:
- The NAV staging system accurately classified patients based on their TOS presentation.
- Therapeutic interventions were guided by the assigned NAV stage.
- Preliminary experience suggests the NAV system is effective for patient grouping.
Conclusions:
- The NAV staging system demonstrates accuracy and utility in categorizing patients with TOS.
- This system offers a standardized approach to guide therapy for TOS.
- Further validation through a prospective multicenter study is recommended for universal acceptance.