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Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
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Arterial thoracic outlet syndrome.

Brian Daniels1, Leslie Michaud, Franklin Sease

  • 11Steadman Hawkins Clinic of the Carolinas, Greenville Health Systems, Greenville, SC; 2Drisko, Fee, and Parkins, Independence, MO; 3University of South Carolina School of Medicine, Greenville, SC; and 4Vascular Health Alliance, Greenville Health Systems, Greenville, SC.

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Arterial thoracic outlet syndrome, a rare cause of shoulder pain, involves artery compression. Prompt diagnosis and surgical treatment enable athletes to safely return to sports.

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Area of Science:

  • Orthopedics
  • Vascular Surgery
  • Sports Medicine

Background:

  • Arterial thoracic outlet syndrome (ATOS) is a rare condition causing shoulder pain due to subclavian or axillary artery compression.
  • It is the least common form of thoracic outlet syndrome, posing significant morbidity risks.

Purpose of the Study:

  • To highlight the clinical presentation, diagnostic approach, and management of arterial thoracic outlet syndrome in athletes.

Main Methods:

  • Review of clinical presentation, emphasizing exertional pain and arm discomfort in athletes.
  • Diagnostic emphasis on history, physical examination, and imaging to confirm arterial compression.
  • Evaluation of surgical interventions for alleviating vascular compression.

Main Results:

  • Athletes may experience exertional pain, fatigability, or aching in the affected arm.
  • History and physical exam are crucial for initial diagnosis, with imaging confirming anatomical details.
  • Surgical repair or resection effectively resolves compression.

Conclusions:

  • Early recognition of arterial thoracic outlet syndrome is vital for prompt diagnosis and treatment.
  • Surgical intervention allows for a safe return to athletic participation.
  • Understanding this condition improves patient outcomes and management strategies.