Impedance plethysmographic observations in thoracic outlet syndrome

Forty patients with symptoms of neuro-vascular compression in the upper extremities were subjected to impedance plethysmographic study using Parulkar's method. Two patients recorded decreased blood flow (BFI) in supine position and were diagnosed as having partial occlusion at subclavian level. Sixteen of the patients recorded decreased BFI on 90 degrees abduction and hyper-abduction. Twelve of these patients had radiological evidence of anomalous cervicle ribs. In remaining four patients extrinsic impression on the subclavian artery due to fibrous deposits was confirmed by arteriography. Remaining 22 patients recorded normal impedance plethysmograms. Impedance plethysmography thus provided a non-invasive modality for confirmation of vascular compression in thoracic outlet syndrome.