title: Vascular compression syndromes.
abstract: Dealing with vascular compression syndromes is one of the most challenging tasks in Vascular Medicine practice. This heterogeneous group of disorders is characterised by external compression of primarily healthy arteries and/or veins as well as accompanying nerval structures, carrying the risk of subsequent structural vessel wall and nerve damage. Vascular compression syndromes may severely impair health-related quality of life in affected individuals who are typically young and otherwise healthy. The diagnostic approach has not been standardised for any of the vascular compression syndromes. Moreover, some degree of positional external compression of blood vessels such as the subclavian and popliteal vessels or the celiac trunk can be found in a significant proportion of healthy individuals. This implies important difficulties in differentiating physiological from pathological findings of clinical examination and diagnostic imaging with provocative manoeuvres. The level of evidence on which treatment decisions regarding surgical decompression with or without revascularisation can be relied on is generally poor, mostly coming from retrospective single centre studies. Proper patient selection is critical in order to avoid overtreatment in patients without a clear association between vascular compression and clinical symptoms. With a focus on the thoracic outlet-syndrome, the median arcuate ligament syndrome and the popliteal entrapment syndrome, the present article gives a selective literature review on compression syndromes from an interdisciplinary vascular point of view.
authors.affiliation: 1 Division of Vascular Medicine, Medical Clinic and Policlinic IV, Vascular Center, Hospital of the Ludwig-Maximilians-University Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Czihal
authors.affiliation: 2 Division of Vascular and Endovascular Surgery, Vascular Center, Hospital of the Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Ramin
authors.initials: R
authors.lastname: Banafsche
authors.affiliation: 1 Division of Vascular Medicine, Medical Clinic and Policlinic IV, Vascular Center, Hospital of the Ludwig-Maximilians-University Munich, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hoffmann
authors.affiliation: 3 Department of Vascular Surgery, Asklepios Hospital St. Georg, Hamburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Koeppel
mesh_terms: D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D002445:Celiac Artery / Q000002:abnormalities* / Q000503:physiopathology; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D003952:Diagnostic Imaging / Q000379:methods; D006801:Humans; D000074742:Median Arcuate Ligament Syndrome; D011150:Popliteal Artery / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D013901:Thoracic Outlet Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy
keywords: Dunbar`s syndrome; Vascular compression syndrome; median arcuate ligament syndrome; popliteal entrapment syndrome; thoracic outlet syndrome