Anomalous vasculature as direct cause of upper brachial plexus thoracic outlet syndrome
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Updated: Jun 29, 2026

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
Published on: September 13, 2020
George D Chloros1, Nicholas Crosby, Peter Apel
1Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. gchlorosdoc@gmail.com
Abstract:
Direct vascular etiologies of upper plexus thoracic outlet syndrome (TOS) other than the subclavian vessels are exceptional. This is a unique case of an anomalous artery and its accompanying vein causing direct compression to the upper brachial plexus causing TOS. All symptoms resolved after successful treatment consisting of ligation and resection of the vessels. This case demonstrates that although direct vascular etiologies causing upper plexus TOS are extremely uncommon, they should be considered in the differential diagnosis.
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