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Vascular Thoracic Outlet Syndrome.

Mohamad Anas Hussain1, Badr Aljabri2, Mohammed Al-Omran3

  • 1Division of Vascular Surgery, Li Ka Shing Knowledge Institute of St. Michael׳s Hospital, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Ontario, Canada.

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Summary

Vascular thoracic outlet syndrome (TOS) includes venous and arterial types. Minimally invasive endovascular techniques are evolving the diagnosis and management of these rare but significant conditions.

Keywords:
Thoracic outlet syndromearterial thoracic outlet syndromesubclavian arterysubclavian veinvenous thoracic outlet syndrome

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Area of Science:

  • Vascular Surgery
  • Interventional Radiology

Background:

  • Vascular thoracic outlet syndrome (TOS) encompasses venous TOS (subclavian vein compression) and arterial TOS (subclavian artery compression).
  • These subtypes are rare, affecting approximately 3% (venous) and <1% (arterial) of all TOS patients.
  • Traditional diagnostic and management strategies are evolving with advancements in endovascular techniques.

Purpose of the Study:

  • To provide a contemporary review of vascular TOS.
  • To discuss anatomical factors, etiology, pathogenesis, and clinical presentation.
  • To outline current diagnostic and management approaches for venous and arterial TOS.

Main Methods:

  • Review of current literature and observational evidence.
  • Discussion of anatomical considerations and pathophysiology.
  • Analysis of diagnostic criteria and treatment modalities.

Main Results:

  • Vascular TOS requires distinct diagnostic and management strategies based on venous or arterial involvement.
  • Minimally invasive endovascular techniques, including thrombolysis and angioplasty, are increasingly important.
  • A contemporary approach integrates anatomical understanding with evidence-based treatment options.

Conclusions:

  • Accurate diagnosis and tailored management are crucial for patients with venous and arterial TOS.
  • Endovascular interventions represent a significant advancement in treating vascular TOS.
  • This review provides an updated framework for understanding and managing vascular TOS.