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    Concomitant neurogenic and vascular thoracic outlet syndrome due to multiple exostoses.
    Ann Card Anaesth 2018 Jan-Mar;21(1):71-73
    Department of Epidemiology and Biostatistics, Neurology and Neurosciences Research center, Qom University of Medical Sciences, Qom, Iran.
    We report a rare case of multiple hereditary exostosis where patient presented with bilateral base of neck exostoses with concurrent compression of brachial plexus and subclavian artery and vein. The patient was a young 26-year-old woman with chief complaints of pain in the left upper extremity, paresthesia in the left ring and little finger, and weakness in hand movement and grip. On referral, history, physical examination, radiological imaging, and electrodiagnostic tests evaluated the patient. Read More

    Upper Extremity Deep Vein Thrombosis: Symptoms, Diagnosis, and Treatment.
    Isr Med Assoc J 2018 Jan;1(20):53-57
    Department of Internal Medicine B, Kaplan Medical Center, Rehovot, affiliated with Hebrew University-Hadassah Medical School, Jerusalem, Israel.
    Background: Upper extremity deep vein thrombosis (UEDVT) is defined as thrombosis of the deep venous system (subclavian, axillary, brachial, ulnar, and radial veins), which drains the upper extremities. It can be caused by thoracic outlet anatomic obstruction, such as Paget-Schroetter syndrome, (primary) or by central intravenous catheters (secondary). UEDVT may be asymptomatic or present with acute severe pain and arm swelling. Read More

    Long-Term Functional Outcome of Surgical Treatment for Thoracic Outlet Syndrome.
    Diagnostics (Basel) 2018 Jan 12;8(1). Epub 2018 Jan 12.
    Department of Vascular Surgery, St Antonius Hospital, 3435CM Nieuwegein, The Netherlands.
    First rib resection for thoracic outlet syndrome (TOS) is clinically successful and safe in most patients. However, long-term functional outcomes are still insufficiently known. Long-term functional outcome was assessed using a validated questionnaire. Read More

    Outcomes following operative management of thoracic outlet syndrome in the pediatric patients.
    Vascular 2018 Jan 1:1708538117747628. Epub 2018 Jan 1.
    1 Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houstan, TX, USA.
    Objectives Thoracic outlet syndrome, a condition commonly reported in adults, occurs infrequently in the pediatric population. The objective of this study was to assess the outcome of surgical interventions of thoracic outlet syndrome in pediatric patients. Methods Clinical records of all pediatric patients with thoracic outlet syndrome who underwent operative repair from 2002 to 2015 in a tertiary pediatric hospital were reviewed. Read More

    Thoracoscopic Versus Transaxillary Approach to First Rib Resection in Thoracic Outlet Syndrome.
    Ann Thorac Surg 2017 Dec 27. Epub 2017 Dec 27.
    Department of Surgery, Kuopio University Hospital, Kuopio, Finland; Heart Center, Kuopio University Hospital, Kuopio, Finland. Electronic address:
    Background: This study assessed the feasibility of fully endoscopic thoracoscopic first rib resection (FRR) in the treatment of neurogenic thoracic outlet syndrome by comparing early outcomes of the thoracoscopic technique against the traditional transaxillary FRR.

    Methods: Between 2009 and 2016, 60 consecutive FRRs were performed on 47 patients with neurogenic thoracic outlet syndrome (13 bilateral procedures). The first 30 procedures were performed using the traditional transaxillary technique, and the novel thoracoscopic technique was used in the next 30 operations with the same indications for operative repair. Read More

    Successful repair of thoracic outlet syndrome in a growing young patient due to posterior sternoclavicular joint dislocation.
    J Thorac Dis 2017 Oct;9(10):E912-E915
    Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea.
    Posterior sternoclavicular dislocation is an extremely rare injury, usually related to heavy trauma, such as a traffic accident. The anatomical proximity of vital mediastinal structures often discourages a closed reduction during emergency situations. In this case report, we present a 17-year-old male patient who was admitted to our emergency department after having fallen down a flight of stairs five days previously. Read More

    Arterial Thoracic Outlet Syndrome and Cerebellar Infarction Following a Stress Fracture of the First Rib and Extensive Callus Formation: A Case Report.
    JBJS Case Connect 2017 Jul-Sep;7(3):e64
    1Departments of Orthopedic Surgery (Y.S., H.U., Y.T., and K.K.), General Thoracic Surgery (K.I. and K.S.), Neurology (N.M. and N.H.), and Human Pathology (T.S.), Juntendo University School of Medicine, Tokyo, Japan.
    Case: Stress fractures of the first rib rarely have been reported in association with sports activities. We report a case of a cerebellar infarction that possibly was associated with arterial thoracic outlet syndrome (aTOS) that developed as a result of extensive callus formation in a young baseball player with a stress fracture of the first rib.

    Conclusion: According to the literature, almost all cases of stress fracture in the first rib have a relatively good prognosis, and there are only a few reports of TOS occurring as a rare late complication. Read More

    Thoracic outlet syndrome.
    Duodecim 2017;133(11):1043-51
    It is important to remember the possibility of nonspecific thoracic outlet syndrome (TOS) when treating patients with neck and upper extremity symptoms. There are no specific diagnostic criteria for the syndrome. Diagnosis is based on symptoms, clinical examination and the ruling out of other causes. Read More

    [Neurogenic thoracic outlet syndrome].
    Ned Tijdschr Geneeskd 2017 ;161(0):D1385
    Catharinaziekenhuis Eindhoven.
    Neurogenic thoracic outlet syndrome (nTOS) is a type of thoracic outlet syndrome (TOS) where compression of the brachial plexus is responsible for development of upper-extremity, head and neck symptoms. We present a 16-year-old and a 34-year-old patient with nTOS. Diagnosis in both cases was done by following the recently published reporting standards for (n)TOS. Read More

    Dynamic CT angiography for the diagnosis of patients with thoracic outlet syndrome: Correlation with patient symptoms.
    J Cardiovasc Comput Tomogr 2017 Dec 2. Epub 2017 Dec 2.
    service d'imagerie GUILLOZ, Hôpital Central, CHU de Nancy, 54000 Nancy, France.
    Introduction: Vasculo-nervous structures serving the upper limbs may be compressed as they pass through three areas: the inter-scalene triangle (IST), the costo-clavicular space (CCS) and the retropectoralis minor space (RMS). The diagnosis of thoracic outlet syndrome (TOS) is essentially clinical, but requires imaging to specify the site of compression, its grade and the existence of predisposing anatomical factors, in order to guide the treatment and eliminate the main differential diagnoses.

    Material And Methods: Images from 141 patients who underwent dynamic CT angiography of the thoracic outlets from June 2008 to January 2015 were analyzed retrospectively. Read More

    Critical Upper Limb Ischemia Due to Brachial Tourniquet in Misdiagnosed Thoracic Outlet Syndrome after Carpal Tunnel Decompression: A Case Report.
    World J Plast Surg 2017 Sep;6(3):375-379
    Plastic and Reconstructive Surgery Unit, Padova University Hospital, Padova, Italy.
    We present the case of a 68-year-old woman, referred to our department for critical upper limb ischemia, which had occurred a few days after homolateral surgical ligamentotomy for carpal tunnel syndrome, diagnosed and confirmed by electromyography, and performed with a brachial tourniquet. The patient was later admitted for subsequent progressive necrosis of the first three fingers of the left hand, accompanied by signs of upper limb ischemia. An accessory cervical rib was identified, completely obliterating the subclavian artery distally at the origin of the suprascapular artery. Read More

    Cervical Rib Prevalence and its Association with Thoracic Outlet Syndrome: A Meta-Analysis of 141 Studies with Surgical Considerations.
    World Neurosurg 2017 Dec 2. Epub 2017 Dec 2.
    Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland; International Evidence-Based Anatomy Working Group, Krakow, Poland.
    Background: Cervical ribs (CR) are supernumerary ribs that arise from the seventh cervical vertebra. In the presence of CR, the boundaries of the interscalene triangle can be further constricted and result in neurovascular compression and thoracic outlet syndrome (TOS). The aim of our study was to provide a comprehensive evidence-based assessment of CR prevalence and their association with TOS as well as surgical approach to excision of CR and surgical patients' characteristics. Read More

    Absence of the subclavius muscle with contralateral subclavius posticus muscle: first imaging report.
    Clin Imaging 2017 Oct 16;49:54-57. Epub 2017 Oct 16.
    Department of Orthopedic Surgery, Kosin University Gospel Hospital, Busan, Republic of Korea.
    We present a case of a 56-year-old man with pain in in his right anterior shoulder, arm, and hand. MRI studies demonstrated absence of the subclavius muscle with contralateral subclavius posticus muscle. To our knowledge, imaging of the total absence of subclavius muscle has not been previously described. Read More

    Long-term outcomes after surgical treatment of pediatric neurogenic thoracic outlet syndrome.
    J Neurosurg Pediatr 2018 Jan 10;21(1):54-64. Epub 2017 Nov 10.
    Department of Neurosurgery, University of Pennsylvania, Philadelphia; and.
    OBJECTIVE Neurogenic thoracic outlet syndrome (nTOS) is an uncommon compression syndrome of the brachial plexus that presents with pain, sensory changes, and motor weakness in the affected limb. The authors reviewed the clinical presentations and outcomes in their series of pediatric patients with surgically treated nTOS over a 6-year period. METHODS Cases of nTOS in patients age 18 years or younger were extracted for analysis from a prospective database of peripheral nerve operations. Read More

    Safety and Efficacy of Catheter-Directed Therapies as a Supplement to Surgical Decompression in Venous Thoracic Outlet Syndrome.
    AJR Am J Roentgenol 2017 Nov 7:W1-W6. Epub 2017 Nov 7.
    1 Division of Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114.
    Objective: The purpose of this study is to evaluate the role of endovascular therapy in the management of venous thoracic outlet syndrome (TOS), with an emphasis on its role after surgical decompression.

    Materials And Methods: This single-center retrospective review identified all patients who underwent conventional contrast-enhanced venography as a component of the imaging evaluation of clinically suspected venous TOS from January 2004 through September 2015. Eighty-one patients were identified, with a mean (± SD) age of 33 ± 12 years, of whom 59% (48/81) were women. Read More

    Posterior Upper Rib Excision for Neurogenic Thoracic Outlet Syndrome, Feasibility and Early Outcomes.
    Oper Neurosurg (Hagerstown) 2017 Jul 6. Epub 2017 Jul 6.
    Department of Neurosurgery, Biruni Uni-versity, Istanbul, Turkey.
    Background: There are several surgical treatment options for neurogenic thoracic outlet syndrome (n-TOS). However, the first rib has been shown to be the common denominator of all TOS forms and the degree of its resection has been shown to correlate with the long-term success.

    Objective: To demonstrate the feasibility of posterior upper rib excision (PURE) and report early outcomes. Read More

    [Upper extremity deep venous effort thrombosis : management of the Paget-Schroetter syndrome in the emergency department].
    Rev Med Liege 2017 Oct;72(10):432-435
    Service des Urgences, Clinique André Renard, Herstal, Belgique.
    We report a case of upper extremity deep venous effort thrombosis complicating a thoracic outlet syndrome in a 44-year-old patient. The appearance of this complication was sudden. A clinical examination followed by imaging with phlebography leads to a quick diagnosis. Read More

    All-endoscopic Brachial Plexus Complete Neurolysis for Idiopathic Neurogenic Thoracic Outlet Syndrome: Surgical Technique.
    Arthrosc Tech 2017 Aug 10;6(4):e967-e971. Epub 2017 Jul 10.
    Alps Surgery Institute, Clinique Générale d'Annecy, Annecy, France.
    Neurogenic thoracic outlet syndrome is caused by a neurologic compression of the brachial plexus before it reaches the arm. Three anatomic areas are common locations for such an entrapment because of their congenital and/or acquired tightness: the interscalene triangle, the costoclavicular space, and the retropectoralis minor space. Because the compression level usually remains unknown, the treatment is still controversial and most teams focus on only one potential site. Read More

    Frequency of the Pectoralis Minor Compression Syndrome in Patients Treated for Thoracic Outlet Syndrome.
    Ann Vasc Surg 2017 Sep 22. Epub 2017 Sep 22.
    Department of Vascular and Thoracic Surgery, University Hospital, Angers, France.
    Background: Pectoralis minor compression syndrome (PMCS) is a compression of the neurovascular structures in the subpectoral tunnel and remains underestimated in the management of patients with thoracic outlet syndrome (TOS). Its underdiagnosis may be responsible for incomplete or failed treatment. The aim of the study was to evaluate the frequency of PMCS in our experience. Read More

    Midterm and long-term follow-up in competitive athletes undergoing thoracic outlet decompression for neurogenic thoracic outlet syndrome.
    J Vasc Surg 2017 Dec 21;66(6):1798-1805. Epub 2017 Sep 21.
    Division of Vascular Surgery, Baylor Heart and Vascular Hospital, Dallas, Tex.
    Background: Neurogenic thoracic outlet syndrome (NTOS) results from compression of the brachial plexus by the clavicle, first rib, and scalene muscles and may develop secondary to repetitive motion of the upper extremity. Athletes routinely perform repetitive motions, and sports requiring significant arm and shoulder use may put the participant at increased risk for NTOS. Competitive athletes who develop NTOS may require first rib resection and scalenectomy (FRRS) for symptomatic relief. Read More

    Arterial thoracic outlet syndrome secondary to hypertrophy of the anterior scalene muscle.
    J Surg Case Rep 2017 Aug 21;2017(8):rjx158. Epub 2017 Aug 21.
    Department of Vascular Surgery, Maimonides Medical Center, Brooklyn, NY 11219, USA.
    Thoracic outlet syndrome (TOS) was first introduced in literature by Peet et al. in 1956. Since then is has been studied extensively and subcategorized into at least four closely related syndrome. Read More

    Stenting of Subclavian Artery True and False Aneurysms: A Systematic Review.
    Ann Vasc Surg 2017 Sep 6. Epub 2017 Sep 6.
    First Department of Surgery, Vascular Unit, Medical School, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.
    Background: Aneurysms of the subclavian artery are usually the result of trauma, atherosclerosis, or thoracic outlet syndrome. Until the 90s, open surgical repair was considered the only therapeutic choice, exhibiting high complication rates. Since the first report of endovascular repair of subclavian aneurysms in 1991, promising results have been published. Read More

    Paget-Schroetter Syndrome Resulting from Thoracic Outlet Syndrome and KAATSU Training.
    Intern Med 2017 Oct 6;56(19):2595-2601. Epub 2017 Sep 6.
    Division of Cardiology, Toho University Ohashi Medical Center, Japan.
    A 29-year-old woman who worked as a KAATSU (a type of body exercise that involves blood flow restriction) instructor visited our emergency room with a chief complaint of swelling and left upper limb pain. Chest computed tomography (CT) showed non-uniform contrast images corresponding to the site from the left axillary vein to the left subclavian vein; vascular ultrasonography of the upper limb revealed a thrombotic obstruction at the same site, leading to a diagnosis of Paget-Schroetter syndrome (PSS). We herein report our experience with a case of PSS derived from thoracic outlet syndrome (TOS), in a patient who was a KAATSU instructor. Read More

    Arterial Thoracic Outlet Syndrome Treated Successfully with Totally Endoscopic First Rib Resection.
    Case Rep Pulmonol 2017 6;2017:9350735. Epub 2017 Aug 6.
    Thoracic Surgery Department, University College London Hospitals (UCLH), NHS Foundation Trust, London, UK.
    Thoracic outlet syndrome (TOS) is a constellation of signs and symptoms caused by compression of the neurovascular structures in the thoracic outlet. TOS may be classified as either neurogenic TOS (NTOS) or vascular TOS: venous TOS (VTOS) or arterial TOS (ATOS), depending on the specific structure being affected. The basis for the surgical treatment of TOS is resection of the first rib, and it may be combined with scalenectomy or cervical rib resection. Read More

    Video-assisted thoracoscopic surgery for intrathoracic first rib resection in thoracic outlet syndrome.
    J Thorac Dis 2017 Jul;9(7):2022-2028
    Department of Thoracic and Cardiovascular Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, South Korea.
    Background: First rib resection is a surgical treatment for decompressing the neurovascular structures in thoracic outlet syndrome (TOS). Historically, extrathoracic approaches have used a posterior, supraclavicular, or transaxillary incision to remove the first rib. In this report, we demonstrate video-assisted thoracoscopic surgery for intrathoracic first rib resection (VATS-IFRR). Read More

    Pectoralis Minor Syndrome: Subclavicular Brachial Plexus Compression.
    Diagnostics (Basel) 2017 Jul 28;7(3). Epub 2017 Jul 28.
    The Department of Surgery, University of Colorado Health Science Center, Aurora, Colorado and Presbyterian-St. Lukes Hospital, Denver, CO 80202, USA.
    The diagnosis of brachial plexus compression-either neurogenic thoracic outlet syndrome (NTOS) or neurogenic pectoralis minor syndrome (NPMS)-is based on old fashioned history and physical examination. Tests, such as scalene muscle and pectoralis minor muscle blocks are employed to confirm a diagnosis suspected on clinical findings. Electrodiagnostic studies can confirm a diagnosis of nerve compression, but cannot establish it. Read More

    Blue-fingered diver: case report.
    Undersea Hyperb Med 2016 Nov-Dec;43(7):835-840
    Division of Hyperbaric Medicine, Intermountain Medical Center, Murray, Utah and Intermountain LDS Hospital, Salt Lake City, Utah U.S.
    Although Raynaud's phenomenon is a well-known consequence of exposure to cold, neither its incidence in recreational divers nor case reports in that population have been reported in the medical literature. We present a case report of the initial manifestation of primary Raynaud's phenomenon during a warm-water scuba dive. A healthy 18-year-old Caucasian male made four open-circuit compressed air scuba dives over two days in the Florida Keys to a maximum depth of 90 feet. Read More

    Recurrent Upper Extremity Thrombosis Associated with Overactivity: A Case of Delayed Diagnosis of Paget-Schroetter Syndrome.
    Case Rep Vasc Med 2017 10;2017:8764903. Epub 2017 Jul 10.
    Department of Internal Medicine, University of Toledo Medical Center, Toledo, OH, USA.
    Paget-Schroetter syndrome is thrombosis of the axillary-subclavian vein that is associated with strenuous and repetitive activity of the upper extremities. Overuse of the arm coupled with external compression results in microtrauma in the intima of the subclavian vein, resulting in the activation of the coagulation cascade. Diagnosis is usually made by Doppler ultrasound and the treatment involves thrombolysis, while routine surgical decompression of the thoracic outlet is controversial. Read More

    Paget-Schroetter syndrome complicated by an incidental pulmonary embolism.
    BMJ Case Rep 2017 Aug 2;2017. Epub 2017 Aug 2.
    Vascular Surgery, Dumfries and Galloway Royal Infirmary, Dumfries, Dumfries and Galloway, UK.
    A young man presented with the severe right upper limb swelling following a heavy weight lifting that was thought to be caused by a biceps tendon rupture. However, subsequent investigations confirmed the diagnosis of Paget-Schroetter syndrome that was associated with an incidental pulmonary embolism. The patient underwent a successful thrombolysis followed by a surgical thoracic outlet decompression. Read More

    Associations between clinical diagnostic criteria and pretreatment patient-reported outcomes measures in a prospective observational cohort of patients with neurogenic thoracic outlet syndrome.
    J Vasc Surg 2017 Aug;66(2):533-544.e2
    Department of Surgery, Center for Thoracic Outlet Syndrome and the Section of Vascular Surgery, Washington University School of Medicine in St. Louis, St. Louis, Mo. Electronic address:
    Objective: Neurogenic thoracic outlet syndrome (NTOS) is caused by dynamic compression of the brachial plexus at the level of the supraclavicular scalene triangle or the subcoracoid (pectoralis minor) space, or both. The purpose of this study was to characterize relationships between 14 clinical diagnostic criteria (CDC) and seven pretreatment patient-reported outcomes measures (PROMs) in a prospective cohort of patients with NTOS.

    Methods: There were 183 new patient referrals between July 1 and December 31, 2015, with 150 (82%) meeting an established set of predefined CDC for NTOS. Read More

    Paget-Schroetter Syndrome in a Baseball Pitcher.
    Int Heart J 2017 Aug 13;58(4):637-640. Epub 2017 Jul 13.
    Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences.
    Paget-Schroetter syndrome (PSS) is thrombosis of the deep veins draining the upper extremity due to anatomic abnormalities of the thoracic outlet that cause subclavian compression and subsequent thrombosis, leading to thrombus formation in the subclavian vein. Vigorous arm activity in sports is a known risk factor. Here, we report a case of Paget-Schroetter syndrome in a 31-year-old male non-professional baseball pitcher. Read More

    Ultrasonographic Diagnosis of Thoracic Outlet Syndrome Secondary to Brachial Plexus Piercing Variation.
    Diagnostics (Basel) 2017 Jul 4;7(3). Epub 2017 Jul 4.
    Department of Anatomy, Midwestern University, Glendale, AZ 85308, USA.
    Structural variations of the thoracic outlet create a unique risk for neurogenic thoracic outlet syndrome (nTOS) that is difficult to diagnose clinically. Common anatomical variations in brachial plexus (BP) branching were recently discovered in which portions of the proximal plexus pierce the anterior scalene. This results in possible impingement of BP nerves within the muscle belly and, therefore, predisposition for nTOS. Read More

    Thoracic outlet syndrome after the Nuss procedure for pectus excavatum: Is it a rare complication?
    J Plast Reconstr Aesthet Surg 2017 Oct 3;70(10):1433-1439. Epub 2017 Jun 3.
    Department of Plastic and Reconstructive Surgery, Medical/Graduate School of Kagawa University, Kagawa, Japan.
    Objective: The present study aims to elucidate the frequency of thoracic outlet syndrome after the Nuss procedure for pectus excavatum and the conditions in which thoracic outlet syndrome is likely to develop.

    Methods: A retrospective study including 85 pectus excavatum patients (58 males and 27 females) was conducted. Thoracic outlet syndrome was defined as a condition in which the patient has numbness, lassitude, or pain of the upper limbs at rest or during motion of the upper limbs. Read More

    Choosing Surgery for Neurogenic TOS: The Roles of Physical Exam, Physical Therapy, and Imaging.
    Diagnostics (Basel) 2017 06 23;7(2). Epub 2017 Jun 23.
    Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Colorado Denver, Denver, CO 80045 USA.
    Neurogenic thoracic outlet syndrome (nTOS) is characterized by arm and hand pain, paresthesias, and sometimes weakness resulting from compression of the brachial plexus within the thoracic outlet. While it is the most common subtype of TOS, nTOS can be difficult to diagnose. Furthermore, patient selection for surgical treatment can be challenging as symptoms may be vague and ambiguous, and diagnostic studies may be equivocal. Read More

    Creating a Registry for Patients with Thoracic Outlet Syndrome.
    Diagnostics (Basel) 2017 Jun 17;7(2). Epub 2017 Jun 17.
    Division of Vascular and Endovascular Surgery, University of California Davis Health, 4860 Y Street, Suite 3400, Sacramento, CA 95817, USA.
    The creation of any patient database requires substantial planning. In the case of thoracic outlet syndrome, which is a rare disease, the Society for Vascular Surgery has defined reporting standards to serve as an outline for the creation of a patient registry. Prior to undertaking this task, it is critical that designers understand the basics of registry planning and a priori establish plans for data collection and analysis. Read More

    Corrosion of Harrington rod in idiopathic scoliosis: long-term effects.
    Eur Spine J 2017 Jun 17. Epub 2017 Jun 17.
    , 11754 County Rd. 29, Roseneath, ON, K0K 2X0, Canada.
    Purpose: Metal implants have been used to treat adolescent idiopathic scoliosis since the 1960s. Only recently, however, it has the issue of metal-bone breakdown secondary to metal corrosion in situ come to light, raising concerns of possible long-term complications from the resulting metallosis and inflammation of spinal tissues. We present a case of a patient with neurological deficit, pain, and disability with Harrington rod in place for over 30 years, to bring attention to the issue of bio-corrosion of metal implants and its effect on human tissue. Read More

    Thoracic outlet syndrome as a consequence of isolated atraumatic first rib fracture.
    J Surg Case Rep 2017 Jun 7;2017(6):rjx100. Epub 2017 Jun 7.
    Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN, USA.
    Neurogenic thoracic outlet syndrome (nTOS) resulting from an isolated first rib fracture is extremely infrequent. We report a case of performance limiting nTOS in a college athlete who was initially evaluated and treated for upper extremity ligamentous injury with only transient improvement. Subsequent noninvasive studies were consistent with TOS physiology and MRA showed a large hypertrophic callus on the first rib adjacent to the brachial plexus. Read More

    Corrective Osteotomy for Symptomatic Clavicle Malunion Using Patient-specific Osteotomy and Reduction Guides.
    Tech Hand Up Extrem Surg 2017 Sep;21(3):91-100
    *Center for Orthopaedic Surgery, State Hospitals Aarau and Baden, Baden †School of Life Sciences, Institute for Medical and Analytical Technologies, University of Applied Sciences Northwestern Switzerland, Muttenz, Switzerland.
    Midshaft clavicular fractures are often treated nonoperatively with good reported clinical outcome in a majority of patients. However, malunion with shortening of the affected clavicle is not uncommon. Shortening of the clavicle has been shown to affect shoulder strength and kinematics with alteration of scapular position. Read More

    Vascular TOS-Creating a Protocol and Sticking to It.
    Diagnostics (Basel) 2017 Jun 10;7(2). Epub 2017 Jun 10.
    Division of Vascular Surgery, Department of Surgery, Ronald Reagan Medical Center at the University of California, Los Angeles, CA 90095, USA.
    Thoracic Outlet Syndrome (TOS) describes a set of disorders that arise from compression of the neurovascular structures that exit the thorax and enter the upper extremity. This can present as one of three subtypes: neurogenic, venous, or arterial. The objective of this section is to outline our current practice at a single, high-volume institution for venous and arterial TOS. Read More

    Thoracic Outlet Syndrome: Getting It Right So You Don't Have to Do It Again.
    Instr Course Lect 2017 Feb;66:103-113
    Fellow, The Philadelphia Hand Center, Thomas Jefferson University, Philadelphia, Pennsylvania.
    Thoracic outlet syndrome is a disorder caused by thoracic outlet compression of the brachial plexus and/or the subclavian vessels. The characteristics of thoracic outlet syndrome are highly variable. Objective tests, such as electrodiagnostic studies, are often unreliable in characterizing thoracic outlet syndrome. Read More

    Current practice of thoracic outlet decompression surgery in the United States.
    J Vasc Surg 2017 Sep 31;66(3):858-865. Epub 2017 May 31.
    Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisc. Electronic address:
    Background: Thoracic outlet syndrome (TOS) and its management are relatively controversial topics. Most of the literature reporting the outcomes of surgical decompression for TOS derives from single-center experiences. The objective of our study was to describe the current state of TOS surgery among hospitals that participate in the American College of Surgeons National Surgical Quality Improvement Program database. Read More

    Isolated Peripheral Nerve Palsies in Thoracic Outlet Syndrome.
    Ann Vasc Surg 2017 Oct 30;44:423.e3-423.e5. Epub 2017 May 30.
    Department of Vascular Surgery, Black Country Vascular Network, Dudley, UK. Electronic address:
    Thoracic outlet syndrome (TOS) poses a difficult diagnostic entity with varied etiology and clinical presentation. We present a 35-year-old gentleman with unilateral long thoracic nerve palsy and contralateral subscapular paralysis caused by aberrant scalenus medius anatomy. TOS ought to be considered in patients presenting with isolated nerve palsies. Read More

    New Diagnostic and Treatment Modalities for Neurogenic Thoracic Outlet Syndrome.
    Diagnostics (Basel) 2017 May 27;7(2). Epub 2017 May 27.
    Department of Surgery, Johns Hopkins Heart and Vascular Institute, Johns Hopkins Medical Centers, Baltimore, MD 21287, USA.
    Neurogenic thoracic outlet syndrome is a widely recognized, yet controversial, syndrome. The lack of specific objective diagnostic modalities makes diagnosis difficult. This is compounded by a lack of agreed upon definitive criteria to confirm diagnosis. Read More

    Perioperative Outcomes of Thoracic Outlet Syndrome Surgical Repair in a Nationally Validated Database.
    Angiology 2017 Jul 14;68(6):502-507. Epub 2016 Nov 14.
    1 Department of Vascular and Endovascular Surgery, Johns Hopkins Medical Institutes, Baltimore, MD, USA.
    We evaluated the occurrence of thoracic outlet syndrome (TOS) and 30-day postoperative outcomes. Patients undergoing cervical/first rib resection surgery were identified in the American College of Surgeons National Surgical Quality Improvement Program database (2005-2013). Thoracic outlet syndrome types were then examined. Read More

    Major Aortopulmonary Collateral Arteries With Anatomy Other Than Pulmonary Atresia/Ventricular Septal Defect.
    Ann Thorac Surg 2017 Sep 17;104(3):907-916. Epub 2017 May 17.
    Division of Pediatric Cardiac Surgery, Lucile Packard Children's Hospital/Stanford University, Stanford, California.
    Background: Major aortopulmonary collateral arteries (MAPCAs) are frequently found in association with pulmonary atresia with ventricular septal defect (PA/VSD). However, some patients with MAPCAs do not have PA/VSD but have a variety of other "atypical" anatomic diagnoses.

    Methods: This was a retrospective review of patients with MAPCAs and atypical anatomy. Read More

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