title: The treatment of subclavian artery compression with the use of ringed polytetrafluoroethylene vascular prostheses.
abstract: In this paper the treatment of arterial complications of the Thoracic Outlet Syndrome (TOS) is presented. The investigation of 14 patients treated in the Department of Vascular, General and Transplantological Surgery of the Wroclaw Medical University for arterial complications of the TOS (as upper limb ischemia and/or the subclavian artery aneurysm in 14 patients) was performed. In case of complications associated with compression of the subclavian artery the operation consisted of resection of the first rib and accessory osseous and muscular pathological elements using supraclavicular and/or infraclavicular approach with implantation of externally supported ringed vascular polytetrafluoroethylene bypass (PTFE) were performed. The therapy results were estimated with use of The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire of American Academy of Orthopedic Surgeons.
  
  
  RESULTS
  In case of upper limb ischemia the improvement of blood flow was obtained after the subclavian-brachial bypass implantation (5 patients). In this group the DASH score showed return to full activity. In case of subclavian artery aneurysm surgery (9 patients) the DASH scale revealed worsening of limb function in 4 patients during follow-up period. The optimal therapy of vascular complications is the multimodal treatment (reconstructive vascular procedure with decompressive surgery). The decompression of neurovascular bundle in vascular TOS should include the first rib resection in each case.
authors.affiliation: Department of Vascular, General and Transplantological Surgery Wrocław University of Medicine. apupka@chirn.am.wroc.pl
authors.forename: Artur
authors.initials: A
authors.lastname: Pupka
authors.forename: Artur
authors.initials: A
authors.lastname: Ruciński
authors.forename: Jan
authors.initials: J
authors.lastname: Skóra
authors.forename: Dariusz
authors.initials: D
authors.lastname: Janczak
authors.forename: Stanislaw
authors.initials: S
authors.lastname: Pawłowski
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Kałuza
authors.forename: Tomasz
authors.initials: T
authors.lastname: Dawiskiba
authors.forename: Piotr
authors.initials: P
authors.lastname: Szyber
mesh_terms: D000293:Adolescent; D000328:Adult; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene / Q000627:therapeutic use*; D013348:Subclavian Artery / Q000637:transplantation*; D013901:Thoracic Outlet Syndrome / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D011138:Polytetrafluoroethylene