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Thoracic outlet arterial compression: prevalence in normal persons
Angiology
|August 1, 1980
Summary
Thoracic outlet artery compression is common in healthy individuals, affecting 60% during specific maneuvers. This finding suggests limited diagnostic value for symptomatic patients with thoracic outlet syndrome.
Area of Science:
- Vascular Surgery
- Diagnostic Imaging
- Anatomy
Background:
- Thoracic outlet syndrome (TOS) can cause neurovascular compression.
- Subclavian and axillary artery compression are key features of arterial TOS.
- Diagnostic criteria for TOS often rely on provocative maneuvers.
Purpose of the Study:
- To determine the prevalence of thoracic outlet artery compression in asymptomatic individuals.
- To assess the diagnostic utility of provocative maneuvers for arterial TOS.
Main Methods:
- Photoplethysmography (PPG) was used to record arterial flow in the index fingers.
- 130 healthy subjects underwent Adson, Costoclavicular, and hyperabduction maneuvers.
- Simultaneous bilateral recordings were performed on both upper extremities.
Main Results:
- Significant arterial obstruction was observed in 60% of subjects (78/130).
- Bilateral compression occurred in 33% of individuals (43/130).
- Compression was frequently elicited by one or more provocative maneuvers.
Conclusions:
- Thoracic outlet artery compression is a common finding in normal individuals.
- The high prevalence of compression in asymptomatic subjects reduces its diagnostic specificity for TOS.
- Rethinking the diagnostic approach for symptomatic arterial TOS may be necessary.