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Updated: Oct 12, 2025
06:57
Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
Published on: September 13, 2020
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Arterial thoracic outlet syndrome.
Junjian Huang1, Jason Lauer1, Omar Zurkiya1
1Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Cardiovascular Diagnosis and Therapy
|November 24, 2021
Summary
Arterial thoracic outlet syndrome (aTOS) stems from subclavian artery compression, often seen in athletes. Diagnosis involves clinical evaluation and imaging, with treatment ranging from physical therapy to surgery for severe cases.
Area of Science:
- Vascular Surgery
- Sports Medicine
- Diagnostic Imaging
Background:
- Thoracic outlet syndrome (TOS) encompasses symptoms from neurovascular compression in the thoracic outlet.
- Arterial TOS (aTOS), though rare, is linked to repetitive overhead arm motions, particularly in athletes.
- Symptoms can include arm pallor, claudication, or coolness due to subclavian artery compression.
Purpose of the Study:
- To review the diagnostic methods for arterial TOS.
- To outline the management strategies for arterial TOS.
- To provide an overview of current approaches to aTOS.
Main Methods:
- Clinical assessment including history, physical examination, and provocative maneuvers.
- Diagnostic imaging such as angiography and MRI.
- Review of treatment modalities including conservative, surgical, and endovascular options.
Main Results:
- aTOS diagnosis relies on a combination of clinical findings and imaging studies.
- Acute thrombosis can lead to limb-threatening ischemia requiring urgent intervention.
- Management varies from conservative physical therapy to surgical decompression for refractory cases.
Conclusions:
- Early diagnosis and appropriate management are crucial for aTOS.
- Surgical or endovascular interventions may be necessary for persistent or severe cases.
- This review aims to consolidate current knowledge on aTOS diagnosis and treatment.
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