title: Surgical management of vascular thoracic outlet syndrome: a teaching hospital experience.
abstract: OBJECTIVE
  Thoracic outlet syndrome (TOS) consists of a group of distinct disorders that are caused by compression of the brachial plexus and/or subclavian artery and vein. The aim of this study was to highlight the different modalities of diagnosing and treating vascular TOS and evaluate outcomes.
  
  
  METHODS
  We conducted a retrospective cohort study between 1999 and 2011 using the medical records database from a teaching hospital.
  
  
  RESULTS
  During the study period, 54 cases with vascular TOS were identified in 38 patients. Bilateral TOS was in 16 patients. The median age of the patients was 33 years (range 12-49), and the majority (79%) were female. Arterial TOS represented forty-nine cases (90.7%). Preoperative information derived from plain x-ray, duplex scanning and in selected cases computed tomography (CT) and/or angiography. Decompression of the TOS was performed through a supraclavicular approach in all cases with scalenectomy coupled with either cervical rib excision (70%), 1st rib excision alone (15%) and excision of both cervical and 1st ribs (15%). Adjunctive vascular reconstructive procedures were done in 11 cases (20.3%); 9 arterial cases and 2 venous cases. There was no mortality; however, postoperative complications occurred in 7 cases (13%).
  
  
  CONCLUSIONS
  The use of advanced radiological imaging and careful surgical planning for Vascular TOS in a high volume center resulted in good outcomes.
authors: Peripheral Vascular Disease Research Chair and Division of Vascular Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors: Badr
authors: B
authors: Aljabri
authors: Mohammed
authors: M
authors: Al-Omran
keywords: subclavian artery; subclavian vein; thoracic outlet syndrome
references: J Vasc Surg. 2010 Aug;52(2):406-11
references: 20541346
references: Ann Thorac Surg. 2003 Aug;76(2):396-9; discussion 399-400
references: 12902072
references: AJR Am J Roentgenol. 2000 Jun;174(6):1667-74
references: 10845503
references: Proc (Bayl Univ Med Cent). 2007 Apr;20(2):125-35
references: 17431445
references: Cardiovasc Intervent Radiol. 2011 Oct;34(5):903-10
references: 21448772
references: J Vasc Surg. 1989 Dec;10(6):626-34
references: 2585651
references: Neurosurgery. 2004 Oct;55(4):897-902; discussion 902-3
references: 15458598
references: Proc Staff Meet Mayo Clin. 1956 May 2;31(9):281-7
references: 13323047
references: Curr Treat Options Cardiovasc Med. 2009 Apr;11(2):176-83
references: 19289030
references: Ann Vasc Surg. 1999 May;13(3):268-74
references: 10347259
references: Saudi Med J. 2012 Jan;33(1):66-9
references: 22273651
references: Vasc Endovascular Surg. 2012 Feb;46(2):157-62
references: 22308211
references: Rev Med Interne. 1990 Jan-Feb;11(1):19-24
references: 2183322
references: J Vasc Surg. 1988 Sep;8(3):329-34
references: 3418832
references: Vasc Endovascular Surg. 2007 Aug-Sep;41(4):316-21
references: 17704334
references: Eur J Vasc Endovasc Surg. 2003 Aug;26(2):170-5
references: 12917833
references: Chest Surg Clin N Am. 2000 Feb;10(1):183-8, x-xi
references: 10689536
references: J Ultrasound Med. 2001 Jul;20(7):795-801
references: 11444739
references: J Vasc Surg. 2007 Sep;46(3):601-4
references: 17826254
references: Hand Clin. 2004 Feb;20(1):15-6, v
references: 15005378