Computed tomography angiography to evaluate thoracic outlet neurovascular compression.
The objective was to evaluate the efficacy of computed tomography angiography with upper extremity hyperabduction to diagnose thoracic outlet syndrome. Over 5 years, 21 patients were treated surgically for neurogenic symptoms of thoracic outlet syndrome. For patients whose diagnosis was unclear after history and physical examination, adjunctive tests (duplex, magnetic resonance angiography, or computed tomography angiography) were performed to help establish the diagnosis. Five of the 6 computed tomography angiograms were positive. The sixth computed tomography was deemed to be an incomplete study. With mean follow-up of 9.4 months, 95% (n = 19) of patients with a positive hyperabduction test on physical examination were free of symptoms postoperatively. All patients with a positive computed tomography angiogram, with their neurovascular compression localized to the thoracic outlet, had successful operative decompression. Computed tomography angiogram with abduction of the arm can be used as an adjunct to confirm the diagnosis of neurovascular compression and then predict successful operative decompression.
Hasanadka
Ravishankar
R
Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Towne
Jonathan B
JB
Seabrook
Gary R
GR
Brown
Kellie R
KR
Lewis
Brian D
BD
Foley
W Dennis
WD
D000293:Adolescent; D000328:Adult; D000792:Angiography / Q000379:methods*; D016009:Chi-Square Distribution; D003287:Contrast Media; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D007479:Iopamidol; D008297:Male; D008875:Middle Aged; D013901:Thoracic Outlet Syndrome / Q000000981:diagnostic imaging* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
D003287:Contrast Media; D007479:Iopamidol