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Review
. 2014:2014:248163.
doi: 10.1155/2014/248163. Epub 2014 Jul 20.

Understanding thoracic outlet syndrome

Julie Freischlag  1 , Kristine Orion  2
Affiliations
Review

Understanding thoracic outlet syndrome

Julie Freischlag et al. Scientifica (Cairo). 2014.

Abstract

The diagnosis of thoracic outlet syndrome was once debated in the world of vascular surgery. Today, it is more understood and surprisingly less infrequent than once thought. Thoracic outlet syndrome (TOS) is composed of three types: neurogenic, venous, and arterial. Each type is in distinction to the others when considering patient presentation and diagnosis. Remarkable advances have been made in surgical approach, physical therapy, and rehabilitation of these patients. Dedicated centers of excellence with multidisciplinary teams have been developed and continue to lead the way in future research.

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Figures

Figure 1
Figure 1
Anatomy of the thoracic outlet (reprinted with permission of Elsevier; see [8]).
Figure 2
Figure 2
Radiographs show both a fully formed and a partially developed cervical rib (reprinted with permission of Elsevier; see [8]).
Figure 3
Figure 3
Machleder retractor with incision marked just below axillary hair line.
Figure 4
Figure 4
Use of the periosteal elevator to remove tissue from the first rib (reprinted with permission of Elsevier; see [8]).
Figure 5
Figure 5
Transection of the anterior scalene muscle with a right angle clamp and scissors (reprinted with permission of Elsevier; see [8]).
Figure 6
Figure 6
First rib removed.
See this image and copyright information in PMC

References

    1. Machleder H. A brief history of the thoracic outlet compression syndromes. In: Illig KA, Thompson RW, Freischlag JA, Donahue DM, Jordan SE, Edgelow PI, editors. Thoracic Outlet Syndrome. New York, NY, USA: Springer; 2013. pp. 3–9.
    1. Tubbs RS, Shoja MM. Embryology of the thoracic outlet. In: Illig KA, Thompson RW, Freischlag JA, Donahue DM, Jordan SE, Edgelow PI, editors. Thoracic Outlet Syndrome. New York, NY, USA: Springer; 2013.
    1. Sanders RJ. Anatomy and pathophysiology of ATOS. In: Illig KA, Thomson RW, Freischlag JA, Donahue DM, Jordan SE, Edgelow PI, editors. Thoracic Outlet Syndrome. Springer; 2013.
    1. Feinberg RL. Clinical presentation and patient evaluation in VTOS. In: Illig KA, Thompson RW, Freischlag JA, Donahue DM, Jordan SE, Edgelow PI, editors. Thoracic Outlet Syndrome. London, UK: Springer; 2013. pp. 345–353.
    1. A. J. Doyle; K. A. Illig. Thoracic Outlet Syndrome. Springer; 2013. VTOS for the primary care team: when to consider the diagnosis.

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