Thoracic outlet syndrome: a narrative review

Area of Science:

• Medical Science
• Anatomy
• Pathophysiology

Background:

• Thoracic Outlet Syndrome (TOS) arises from compression of the brachial plexus, subclavian artery, or subclavian vein.
• Compression occurs in the thoracic outlet, often between the clavicle and first rib, due to anatomical variations.
• Neurological compression is the most common TOS form, while vascular complications (arterial and venous) are infrequent.

Purpose of the Study:

• To conduct a narrative review of Thoracic Outlet Syndrome (TOS).
• Focus on TOS etiology, pathophysiology, epidemiology, clinical evaluation, diagnostic methods, differential diagnoses, and treatment strategies.
• Address the lack of epidemiological data for TOS in Brazil.

Main Methods:

• Narrative review of existing literature on Thoracic Outlet Syndrome.
• Synthesis of information regarding TOS causes, symptoms, and management.
• Analysis of risk factors including biotype, genetics, age, and gender.

Main Results:

• Neurogenic TOS accounts for over 95% of cases.
• Venous TOS represents 2-3% of cases, and arterial TOS approximately 1%.
• Risk factors include individual variations like genetics, age, and gender, with specific epidemiological data lacking for Brazil.

Conclusions:

• Thoracic Outlet Syndrome diagnosis requires thorough clinical evaluation and complementary testing.
• Treatment is tailored to the specific etiology and presence of complications.
• Further epidemiological studies in Brazil are needed to understand TOS prevalence.