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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
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Updated: Dec 22, 2025

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
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ACR Appropriateness Criteria® Thoracic Outlet Syndrome.

, Omar Zurkiya1, Suvranu Ganguli2

  • 1Research Author, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts.

Journal of the American College of Radiology : JACR
|May 7, 2020
PubMed
Summary
This summary is machine-generated.

Thoracic outlet syndrome (TOS) involves compression of nerves and blood vessels in the neck. This guide clarifies appropriate imaging for neurogenic, venous, and arterial TOS based on symptoms.

Keywords:
AUCAppropriate Use CriteriaAppropriateness CriteriaNeurogenic thoracic outlet syndromePaget-Schroetter diseaseThoracic outlet syndromeVenous thoracic outlet syndrome

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Area of Science:

  • Radiology
  • Vascular Surgery
  • Neurology

Background:

  • Thoracic outlet syndrome (TOS) is characterized by compression of the brachial plexus, subclavian artery, or subclavian vein.
  • Symptoms vary based on the compressed structure, leading to neurogenic, venous, or arterial TOS variants.
  • Patients may present with multiple simultaneous symptoms.

Framework:

  • This publication outlines imaging appropriateness tailored to specific TOS variants (neurogenic, venous, arterial).
  • It considers the interplay of anatomical spaces, causes of narrowing, and resulting neurovascular changes.
  • Guidelines address both preoperative and postoperative scenarios, acknowledging symptom evolution.

Implementation:

  • The American College of Radiology Appropriateness Criteria provide evidence-based guidelines.
  • A multidisciplinary expert panel annually reviews and revises these guidelines.
  • Methodologies like RAND/UCLA and GRADE ensure rigorous evaluation of imaging and treatment procedures.

Implications:

  • Accurate diagnosis and intervention planning for TOS rely on appropriate radiological imaging.
  • Understanding TOS variants guides the selection of diagnostic studies.
  • Expert opinion supplements evidence where data is limited, ensuring comprehensive recommendations.