[Diagnosis and surgical treatment results in neurovascular thoracic outlet compression syndrome]

A detailed study of 44 patients with the neuro-vascular compression syndrome of thoracic exit has established the diagnostic value of clinical and special methods of diagnosing the disease. The most frequent symptoms were pain in the anterior scalene muscle (ASM) during palpation (96%) and paresthesia in fingers (93%). Rheography, arteriography and phlebography of the upper extremities combined with the positional tests should be resorted to. In case of marked neurological symptoms the data on the nerve block of the ASM are informative. Surgical treatment was undertaken in 35 patients: resection of the I rib in 14 cases (in 4 resection combined with upper thoracic sympathectomy), resection of the ASM in 12, removal of the accessory cervical rib with scalenotomy in 5, decompressive vascular reconstructive operations in 10 patients with vascular complications. Good results were obtained in 32 patients. It is stressed that detailed examinations of patients with vaso-neurological symptoms in the upper extremity are important for timely diagnosis and surgery before the complications supervene.