2,768 results match your criteria Thoracic Outlet Syndrome


Traditional medicine treatment for thoracic outlet syndrome: A protocol for systematic review of randomized controlled trials.

Medicine (Baltimore) 2020 Jul;99(27):e21074

Jisung-Kyunghee Korean Medicine Clinic, Seoul, Republic of Korea.

Background: Diagnosis of thoracic outlet syndrome (TOS) is challenging; however, proper evaluation and treatment ensure relief from symptoms in most patients. A comprehensive approach to treatment is important, considering the multifactorial etiology of TOS. The objective of this systematic review is to describe the methods for evaluating the effectiveness and safety of acupuncture-based traditional medicine treatments for TOS. Read More

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http://dx.doi.org/10.1097/MD.0000000000021074DOI Listing

Posteriorly displaced salter halter fracture-dislocation at the sternoclavicular joint with associated thoracic outlet syndrome: A case report.

Int J Surg Case Rep 2020 Jun 11;72:245-250. Epub 2020 Jun 11.

Department of Trauma and Orthopaedics, Beaumont Hospital, Dublin, Ireland.

Introduction: Posterior sternoclavicular joint fracture-dislocations are a rare and often missed diagnosis. They represent <1% of shoulder girdle injuries and are nine times less common than anterior dislocations. These injuries can be associated with life-threatening complications such as compression of the superior mediastinal structures including the great vessels and brachial plexus. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.06.025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7300244PMC

Reply.

J Vasc Surg Venous Lymphat Disord 2020 Jul;8(4):701-702

The Center for Thoracic Outlet Syndrome and the Section of Vascular Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Mo.

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http://dx.doi.org/10.1016/j.jvsv.2020.02.016DOI Listing

REACT - A novel flow-independent non-gated non-contrast MR angiography technique using magnetization-prepared 3D non-balanced dual-echo dixon method: Preliminary clinical experience.

Eur J Radiol Open 2020 7;7:100238. Epub 2020 Jun 7.

Department of Radiology, Changi General Hospital, 2 Simei Street 3, 529889, Singapore.

Flow-independent relaxation-based non-contrast MR angiography techniques yield good signal-to-noise ratio and high blood-tissue contrast, complementing non-contrast flow-dependent and contrast-enhanced MR angiography techniques in the assessment of vascular disorders. However, these techniques often suffer from imaging artifacts at high magnetic field strengths or across large fields-of-view. Relaxation-Enhanced Angiography without Contrast and Triggering (REACT) is a recently introduced flow-independent non-gated non-contrast three-dimensional MR angiography technique that has been developed to mitigate some of these issues. Read More

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http://dx.doi.org/10.1016/j.ejro.2020.100238DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286964PMC

First rib resection by VATS for thoracic outlet syndrome.

Multimed Man Cardiothorac Surg 2020 Jun 10;2020. Epub 2020 Jun 10.

Centre Hospitalier Universitaire Vaudois Rue du Bugnon 46 1011 Lausanne Switzerland.

The goal of surgical treatment of thoracic outlet syndrome is to decompress the thoracic outlet. There is no consensus regarding the surgical approach. Thoracic outlet decompression can be performed by direct open transaxillary, supraclavicular, and infraclavicular procedures, and the decision regarding which to choose can be a difficult one. Read More

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http://dx.doi.org/10.1510/mmcts.2020.027DOI Listing

A Surgical View of Anatomy: Perspectives from Students and Instructors.

Anat Sci Educ 2020 Jun 8. Epub 2020 Jun 8.

Harvard Medical School, Harvard University, Boston, Massachusetts, United States.

As curricular emphasis on anatomy in undergraduate medical education continues to evolve, new approaches to anatomical education are urgently needed to prepare medical students for residency. A surgical anatomy class was designed for third- and fourth-year medical students to explore important anatomical relationships by performing realistic surgical procedures on anatomical donors. Under the guidance of both surgeons and anatomists, students in this month-long elective course explored key anatomical relationships through performing surgical approaches, with the secondary benefit of practicing basic surgical techniques. Read More

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http://dx.doi.org/10.1002/ase.1988DOI Listing

Thoracic Outlet Syndrome in the Overhead Athlete: Diagnosis and Treatment Recommendations.

Curr Rev Musculoskelet Med 2020 Aug;13(4):457-471

Washington University School of Medicine and Barnes-Jewish Hospital, 660 S. Euclid, Campus, Box 8109, St. Louis, MO, 63110, USA.

Purpose Of Review: Neurovascular compression in the upper extremity is rare but can affect even those participating in high-level competitive athletics. To assess optimal approaches to treatment, in this review, we evaluate the current literature on neurovascular compressive syndromes affecting the upper extremity, with a special focus on the thoracic outlet syndrome (TOS).

Recent Findings: Neurovascular compression at the thoracic outlet can involve the brachial plexus, subclavian artery, or subclavian vein, each with distinct clinical manifestations. Read More

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http://dx.doi.org/10.1007/s12178-020-09643-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340704PMC

Comments on: "Thoracic outlet syndrome: diagnostic accuracy of MRI" of A Hardy, C Pougès, G Wavreille, H Behal, X Demondion, G Lefebvre published in Orthop Traumatol Surg Res OTSR. 2019;105(8):1563-9.

Orthop Traumatol Surg Res 2020 Jun 4. Epub 2020 Jun 4.

Department of Neurosurgery, University of California, San Francisco (UCSF), 400, Parnassus Ave, 94143 San Francisco, CA, USA.

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http://dx.doi.org/10.1016/j.otsr.2020.05.001DOI Listing

A critical overview of the current myofascial pain literature - January 2020.

J Bodyw Mov Ther 2020 Apr 29;24(2):213-224. Epub 2020 Apr 29.

Myopain Seminars, Bethesda, MD, USA; New Orleans Pelicans, New Orleans, LA, USA. Electronic address:

We are starting 2020 with 6 basic research studies, 9 review articles, 14 dry needling/injection studies, and one manual therapy paper for a total of 30 new papers. Topics range from studies on mechanisms, inflammatory mediators in myofascial pain, fascia, screening, Platelet-rich plasma intramuscular injections, and temporal summation to clinical studies on patients with tension-type headache, chronic pelvic pain, knee osteoarthritis, plantar fasciitis, generalized musculoskeletal pain, neck pain, breast cancer, tendinopathies, thoracic outlet syndrome, and canine dry needling, among others. Read More

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http://dx.doi.org/10.1016/j.jbmt.2020.04.001DOI Listing

Posterior cerebral artery stroke by reverse flow embolism in thoracic outlet syndrome - a case report.

BMC Neurol 2020 Jun 4;20(1):229. Epub 2020 Jun 4.

Department of neurology and stroke center, Versailles Mignot Hospital, 78150, Le Chesnay, France.

Background: Arterial thoracic outlet syndrome is a rare condition characterized by a subclavian artery pathology associated with a bone abnormality. It is rarely associated with thromboembolic stroke. The mechanism of cerebral embolism associated with thoracic outlet syndrome have rarely been demonstrated. Read More

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http://dx.doi.org/10.1186/s12883-020-01797-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7271554PMC

Special Communication: Evaluation and Treatment of Thoracic Outlet Syndrome During the Global Pandemic Due to SARS-CoV-2 and COVID-19.

J Vasc Surg 2020 Jun 1. Epub 2020 Jun 1.

The Center for Thoracic Outlet Syndrome and the Section of Vascular Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO. Electronic address:

The global SARS-CoV-2/COVID-19 pandemic has required a reduction in non-emergency treatment for a variety of disorders. This report summarizes conclusions of an international multidisciplinary consensus group assembled to address evaluation and treatment of patients with thoracic outlet syndrome (TOS), a group of conditions characterized by extrinsic compression of the neurovascular structures serving the upper extremity. The following recommendations were developed in relation to the 3 defined types of TOS (neurogenic, venous, and arterial) and 3 phases of pandemic response (preparatory, urgent with limited resources, and emergency with complete diversion of resources): (1) In-person evaluation and treatment for neurogenic TOS (interventional or surgical) is generally postponed during all pandemic phases, with telephone/telemedicine visits and at-home physical therapy exercises recommended when feasible. Read More

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http://dx.doi.org/10.1016/j.jvs.2020.05.048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262516PMC

Venous Thoracic Outlet Syndrome in a Young Student.

J Emerg Med 2020 May 26. Epub 2020 May 26.

Department of Emergency Medicine, The Ohio State University, Columbus, Ohio.

Background: Venous thoracic outlet syndrome (VTOS) results from compression and thrombosis of the axillosubclavian vein. In primary effort thrombosis, a subtype of VTOS, chronic repetitive compression injury of the axillosubclavian vein leads to scarring, stenosis, and eventually, thrombosis. This is a rare manifestation of an upper extremity deep vein thrombosis. Read More

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http://dx.doi.org/10.1016/j.jemermed.2020.04.044DOI Listing

The Adipofascial Deltopectoral Flap to Cover the Brachial Plexus in Thoracic Outlet Syndrome and Radiation Plexitis.

J Plast Reconstr Aesthet Surg 2020 Mar 13. Epub 2020 Mar 13.

Oxford Reconstructive Plastic Hand surgery Innovation Collaboration (ORPHIC), Department of Plastic, Reconstructive and Hand Surgery, Oxford University Hospitals NHS Foundation Trust, United Kingdom.

Revascularisation of the brachial plexus is controversial. Traditional techniques use free tissue transfer of omentum, groin fat or muscle, on the principle of supplying rich quantities of vascularised tissue to wrap around the nerves permitting neural gliding and revascularising the scarred nerves. However, the complexity of an additional microsurgical procedure coupled with uncertainty of their effectiveness have curtailed their clinical application. Read More

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http://dx.doi.org/10.1016/j.bjps.2020.02.039DOI Listing

Manubrial pseudolesion: a secondary sign of thoracic outlet syndrome.

Clin Imaging 2020 May 16;66:98-100. Epub 2020 May 16.

Department of Radiology, University of California San Diego, 408 Dickinson Street, Mail code 8226, San Diego, CA 92103, USA. Electronic address:

Marrow enhancement mimicking sclerotic osseous disease, or the so-called transient "pseudolesion," has frequently been described in vertebral bodies supplied by collateral basivertebral venous flow in the setting of central venous obstruction. Pseudolesions involving the sternum are much rarer and have only been described in the setting of malignant central venous obstruction. We report a case of an incidental manubrial pseudolesion on contrast-enhanced CT prompting further investigation for thoracic outlet syndrome. Read More

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http://dx.doi.org/10.1016/j.clinimag.2020.05.015DOI Listing

Postoperative outcomes in thoracic outlet decompression for acute versus chronic venous thoracic outlet syndrome.

J Vasc Surg Venous Lymphat Disord 2020 May 25. Epub 2020 May 25.

University of Pittsburgh Medical School, Pittsburgh, Pennsylvania.

Objective: Venous thoracic outlet syndrome (VTOS) is a rare disorder that occurs in young athletes and working adults. There are multiple published reports demonstrating excellent outcomes with thoracic outlet (TO) decompression surgery when patients present acutely (within 2 weeks of symptom onset). Our objective was to assess outcomes following decompression surgery in patients with acute, subacute, chronic, and secondary VTOS. Read More

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http://dx.doi.org/10.1016/j.jvsv.2020.05.010DOI Listing

Robotic-Assisted First Rib Resection: Our Experience and Review of the Literature.

Semin Thorac Cardiovasc Surg 2020 May 21. Epub 2020 May 21.

Department of Cardiovascular and Thoracic Surgery, Hofstra Northwell School of Medicine, Queens, New York.

Thoracic outlet syndrome (TOS) comprises a constellation of signs and symptoms that arise from neurologic and vascular compression of the brachial plexus and subclavian vasculature, respectively. Surgical decompression of the neurovascular structures is often indicated to alleviate TOS. We report here our robotic surgical approach and experience for resection of the first rib. Read More

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http://dx.doi.org/10.1053/j.semtcvs.2020.04.016DOI Listing

Long-term outcome after nonsurgical management of Paget-Schroetter syndrome.

J Vasc Surg Venous Lymphat Disord 2020 May 20. Epub 2020 May 20.

Department of Vascular Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv, Israel.

Objective: Paget-Schroetter syndrome (PSS) is an uncommon disease with potentially debilitating long-term effects. The optimal therapy for PSS is unclear, and the role of surgical decompression of the thoracic outlet is still being questioned. In this study, we present long-term results of patients treated with catheter-directed thrombolysis (CDT) and anticoagulation without surgical management. Read More

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http://dx.doi.org/10.1016/j.jvsv.2020.04.027DOI Listing

Supraclavicular Resection of a Cervical Rib Causing Thoracic Outlet Syndrome: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2020 May 23. Epub 2020 May 23.

Miami Project to Cure Paralysis, Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, Florida.

Presence of a cervical rib results from overdevelopment of the seventh cervical vertebrae.1-3 The cervical rib along with scalene muscles can cause neurogenic thoracic outlet syndrome.4,5 Rib resection is typically done via anterior approach, using either supraclavicular or transaxillary route. Read More

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http://dx.doi.org/10.1093/ons/opaa139DOI Listing

Efficacy of intensive, hospital-based rehabilitation in cases of thoracic outlet syndrome that failed to respond to private-practice physiotherapy.

J Back Musculoskelet Rehabil 2020 May 15. Epub 2020 May 15.

Pôle RRSS, Hôpital Swynghedauw, CHU, F-59000 Lille, France.

Background: Rehabilitation is currently the preferred first-line treatment for thoracic outlet syndrome (TOS). When physiotherapy fails, the next treatment option is usually surgery - a complex procedure with potential complications.

Objective: We sought to establish whether an intensive, multidisciplinary, day-hospital-based rehabilitation programme could reduce the symptoms of TOS after the failure of private-practice physiotherapy and before surgery was considered. Read More

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http://dx.doi.org/10.3233/BMR-170906DOI Listing

Effects of kinesio taping on pain, paresthesia, functional status, and overall health status in patients with symptomatic thoracic outlet syndrome: A single-blind, randomized, placebo-controlled study.

Acta Orthop Traumatol Turc 2020 May 22. Epub 2020 May 22.

Department of Physical Medicine and Rehabilitation, Çukurova University, School of Medicine, Adana, Turkey.

Objective: This study aimed to assess the effects of kinesio taping (KT) on pain, paresthesia, functional status, and overall health status in patients with symptomatic thoracic outlet syndrome (sTOS).

Methods: A single-blind placebo-controlled design was employed in this study. The study duration was defined as 12 months. Read More

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http://dx.doi.org/10.5152/j.aott.2020.19042DOI Listing

Comments on: "Thoracic Outlet Syndrome: Diagnostic accuracy of MRI" of A. Hardy, C. Pougès, G. Wavreille, H. Behal, X. Demondion, G. Lefebvre published in Orthop Traumatol Surg Res OTSR. 2019;105(8):1563-9.

Orthop Traumatol Surg Res 2020 Jun 18;106(4):781. Epub 2020 May 18.

Research Department at Medical School, Universidad de Especialidades Espiritu Santo Facultad de Ciencias Medicas, Samborondon, Guayas, Ecuador. Electronic address:

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http://dx.doi.org/10.1016/j.otsr.2020.03.008DOI Listing

Costoclavicular ligament as a novel cause of venous thoracic outlet syndrome: from anatomic study to clinical application.

Surg Radiol Anat 2020 Aug 18;42(8):865-870. Epub 2020 May 18.

Department of Vascular Surgery, Peking Union Medical College Hospital, Shuaifuyuan 1, Dongcheng District, Beijing, 100730, China.

Purpose: Venous thoracic outlet syndrome (VTOS) is a compressive disorder of subclavian vein (SCV); we aimed to investigate the role of costoclavicular ligament (CCL) in the pathogenesis of VTOS.

Methods: A cadaver study was carried out to investigate the presence and morphology of CCL in thoracic outlet regions, as well as its relationship with the SCV. Six formalin-fixed adult cadavers were included, generating 12 dissections of costoclavicular regions (two sides per cadaver). Read More

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http://dx.doi.org/10.1007/s00276-020-02479-7DOI Listing

Deploying Airbag in Motor Vehicle Collision as the Mechanism of Neurogenic Thoracic Outlet Syndrome: A Case Report.

Ann Vasc Surg 2020 May 15. Epub 2020 May 15.

Department of Vascular and Endovascular Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC. Electronic address:

Neurogenic thoracic outlet syndrome (NTOS) is a disorder that is often misdiagnosed and challenging to treat due to the varied and complex mechanisms that precipitate common sensory symptoms associated with neurovascular dysfunction. In this report, we describe a 21-year-old male who presented with left NTOS after being involved in a motor vehicle collision the previous year. Although NTOS is a condition known to develop after motor vehicle collisions, the mechanism of NTOS in this case, the deploying airbag, has not been documented in existing literature. Read More

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http://dx.doi.org/10.1016/j.avsg.2020.04.052DOI Listing

Supraclavicular Versus Transaxillary First Rib Resection for Thoracic Outlet Syndrome.

J Laparoendosc Adv Surg Tech A 2020 Jul 15;30(7):737-741. Epub 2020 May 15.

Division of Vascular Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.

Thoracic outlet syndrome (TOS) results from compression of neurovascular structures supplying the upper extremity as they exit the thoracic outlet. Depending on the clinical presentation, surgical decompression may be required. Transaxillary (TA) and supraclavicular (SC) approaches are both widely utilized and deemed effective. Read More

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http://dx.doi.org/10.1089/lap.2019.0722DOI Listing

ACR Appropriateness Criteria® Thoracic Outlet Syndrome.

J Am Coll Radiol 2020 May;17(5S):S323-S334

Specialty Chair, UMass Memorial Medical Center, Worcester, Massachusetts.

Thoracic outlet syndrome (TOS) is the clinical entity that occurs with compression of the brachial plexus, subclavian artery, and/or subclavian vein at the superior thoracic outlet. Compression of each of these structures results in characteristic symptoms divided into three variants: neurogenic TOS, venous TOS, and arterial TOS, each arising from the specific structure that is compressed. The constellation of symptoms in each patient may vary, and patients may have more than one symptom simultaneously. Read More

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http://dx.doi.org/10.1016/j.jacr.2020.01.029DOI Listing

Long-term Functional Outcomes Follow-Up After 188 Rib Resections in Patients with TOS.

Ann Vasc Surg 2020 Apr 23. Epub 2020 Apr 23.

Division of Vascular Surgery, Department of Surgery, Stanford Hospital and Clinics, Palo Alto, CA. Electronic address:

Introduction: Short term outcomes in patients with all forms of TOS have been widely reported in the literature and have established that rib resection can be beneficial in decompressing the thoracic outlet and relieving pressure on traversing structures. We sought to determine long term functional outcomes using the QuickDASH survey in patients with TOS who underwent rib resection.

Methods: Clinical records for patients who underwent rib resection for TOS at a single institution were retrospectively reviewed. Read More

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http://dx.doi.org/10.1016/j.avsg.2020.04.033DOI Listing

Infrequent origin of a peripheral embolism: Arterial thoracic outlet syndrome in a young woman.

Turk Kardiyol Dern Ars 2020 Apr;48(3):309-311

Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey.

Arterial thoracic outlet syndrome (TOS) is caused by the compression of the subclavian or axillary artery between the ribs and the scalene muscles. Patients may present with various clinical conditions. Herein, we report a case of arterial TOS who presented with peripheral embolism. Read More

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http://dx.doi.org/10.5543/tkda.2019.59056DOI Listing

Ultrasound for Neurogenic Thoracic Outlet Obstruction Remains Theoretical.

Diagnostics (Basel) 2020 Apr 7;10(4). Epub 2020 Apr 7.

Department of Neurosurgery, University of California, San Francisco (UCSF), 400 Parnassus Ave, San Francisco, CA 94143, USA.

We enjoyed reading Povleson et al.'s review entitled "Diagnostic thoracic outlet syndrome: current approaches and future directions" [.. Read More

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http://dx.doi.org/10.3390/diagnostics10040205DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7235746PMC

Recurrent acute limb ischaemia and thoracic outlet syndrome secondary to a clavicle fracture malunion.

ANZ J Surg 2020 Apr 8. Epub 2020 Apr 8.

Department of Orthopedic Surgery, Australian Capital Territory Health, The Canberra Hospital, Canberra, Australian Capital Territory, Australia.

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http://dx.doi.org/10.1111/ans.15893DOI Listing

Miscarriage is associated with cervical ribs in thoracic outlet syndrome patients.

Early Hum Dev 2020 May 1;144:105027. Epub 2020 Apr 1.

Naturalis Biodiversity Center, Leiden, the Netherlands.

The constancy of the number of cervical vertebrae in mammals is probably the result of selection against associated variations. A survey among patients with and without cervical ribs showed an association between miscarriage and the presence of cervical ribs. This supports the hypothesized selection against variations in cervical vertebral number. Read More

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http://dx.doi.org/10.1016/j.earlhumdev.2020.105027DOI Listing

Spinal Cord Stimulation for Neurogenic Thoracic Outlet Syndrome: A Case Report.

A A Pract 2020 Apr;14(6):e01194

From the Department of Pain Management, Anesthesiology Institute, Cleveland Clinic Foundation, Cleveland, Ohio.

Despite conservative and surgical treatments, patients with neurogenic thoracic outlet syndrome can develop debilitating chronic pain of the shoulder and arm. Here we report a case of a patient who failed medical treatment, surgical resection of the first rib, and subsequent resection of rib regrowth with partial excision of a hypertrophied middle scalene muscle. Ultimately, this patient was successfully treated with spinal cord stimulation with dramatic pain relief and remarkable functional improvement for more than 3 years. Read More

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http://dx.doi.org/10.1213/XAA.0000000000001194DOI Listing

Neurogenic Thoracic Outlet Syndrome and other Forms of Cervical Brachial Syndrome Treated with Plasma Concentrate Enriched for Alpha 2 Macroglobulin.

Pain Physician 2020 03;23(2):229-233

Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA.

Background: Existing therapies for myofascial and neuralgic forms of cervicobrachial pain may have unsatisfactory outcomes. Alternative therapies may be considered, particularly for individuals who have failed to respond. Contemporary conceptualizations of chronic pain mechanisms include the contribution of inflammatory factors; therefore, locally targeted antiinflammatory administrations may play a role in treatment of cervicobrachial pain. Read More

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Value of Ultrasound in the Diagnosis of Neurogenic Thoracic Outlet Syndrome.

Eur J Vasc Endovasc Surg 2020 May 18;59(5):852-853. Epub 2020 Mar 18.

Department of Neurology, Catharina Hospital, Eindhoven, the Netherlands. Electronic address:

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http://dx.doi.org/10.1016/j.ejvs.2020.02.016DOI Listing

Minimally Invasive Resection of Symptomatic Cervical Rib for Treatment of Thoracic Outlet Syndrome.

World Neurosurg 2020 Mar 16;139:219-222. Epub 2020 Mar 16.

Jenkins NeuroSpine, New York, New York, USA; Department of Orthopedics, The Mount Sinai Hospital, New York, New York, USA; Department of Neurosurgery, Icahn School of Medicine, The Mount Sinai Hospital, New York, New York, USA. Electronic address:

Background: Neurogenic thoracic outlet syndrome treatments have high morbidity and recurrence rates. We present for the first time to our knowledge a minimally invasive spine surgery technique for complete resection of a cervical rib via a costotransversectomy approach.

Case Description: A patient with an 8-year history of progressive thoracic outlet syndrome presented with right C8 pain, weakness, and atrophy of her right forearm and thenar eminence. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.03.049DOI Listing

Isomerism of the atrial appendages: morphology and terminology.

Cardiovasc Pathol 2020 Jul - Aug;47:107205. Epub 2020 Jan 16.

Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Italy. Electronic address:

Background: Our aim is to identify the pathognomonic anatomical markers and the best terminology to describe the cardiac malformations associated with absent or multiple spleens, which are known as asplenia or polysplenia syndromes or isomerism.

Materials And Methods: We have reviewed 65 hearts with isomerism of atrial appendages of the Anatomical Collections of Congenital Heart Disease, Institute of Pathological Anatomy of the University of Padua consisting of 1800 specimens. All the hearts were classified according to sequential segmental classification. Read More

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http://dx.doi.org/10.1016/j.carpath.2020.107205DOI Listing
July 2020
2.336 Impact Factor

Cervical Rib Synostosis to the First Rib: A Rare Anatomic Variation.

World Neurosurg 2020 06 10;138:187-192. Epub 2020 Mar 10.

School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Background: Congenital anatomic variations exist in human anatomy, which create both diagnostic and treatment challenges. Understanding the osteologic and radiographic anatomy of supernumerary ribs arising from the cervical spine and recognizing the morphologic variations thereof is of great importance to clinicians, radiologists, and surgeons alike.

Case Description: This case study describes osteologic morphology and radiologic characteristics of a rare anatomic variant of a cervical rib (CR): a unilateral, right-sided CR synostosis to the first thoracic rib of a 50-year-old South African man of African ancestry. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.03.009DOI Listing

Differences in quality of life outcomes after paraclavicular decompression for thoracic outlet syndrome.

J Vasc Surg 2020 Feb 27. Epub 2020 Feb 27.

Division of Vascular Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif.

Background: Thoracic outlet syndrome (TOS) results from compression of the neurovascular structures in the thoracic outlet. Decompression provides relief of TOS symptoms. However, little is known about long-term function and quality of life (QoL) from a patient's perspective. Read More

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http://dx.doi.org/10.1016/j.jvs.2019.12.037DOI Listing
February 2020
3.021 Impact Factor

Transthoracic Robotic First Rib Resection: Technique Crystallized.

Ann Thorac Surg 2020 Jul 24;110(1):e71-e73. Epub 2020 Feb 24.

Baylor St Luke's Medical Center, Houston, Texas.

The advantages of transthoracic robotic first rib resection are uncontested exposure of the anatomy of the thoracic outlet and freedom from any neurovascular retraction. The technique of robotic first rib resection is distilled here in a patient with neurogenic thoracic outlet syndrome. Read More

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http://dx.doi.org/10.1016/j.athoracsur.2019.12.086DOI Listing

Acute effects of manual therapy on respiratory parameters in thoracic outlet syndrome.

Turk Gogus Kalp Damar Cerrahisi Derg 2019 Jan 1;27(1):101-106. Epub 2019 Jan 1.

Department of Thoracic Surgery, Medicine Faculty of Ankara University, Ankara, Turkey.

Background: This study aims to investigate the acute effects of manual therapy on pain perception and respiratory parameters in patients with thoracic outlet syndrome.

Methods: The study included 10 patients with thoracic outlet syndrome (1 male, 9 females; mean age 31.3±9. Read More

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http://dx.doi.org/10.5606/tgkdc.dergisi.2019.17375DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7021361PMC
January 2019

Paget-Schroetter syndrome in pregnancy: A case report and discussion of management options.

J Vasc Surg Cases Innov Tech 2020 Mar 12;6(1):59-62. Epub 2020 Feb 12.

Division of Vascular Surgery, Department of Surgery, George Washington University, Washington, D.C.

Paget-Schroetter syndrome is a form of primary venous thoracic outlet syndrome whereby thrombosis of the subclavian vein is instigated by repeated and vigorous overhead activity of the arm. We describe a 35-year-old pregnant white woman at 8 weeks' gestation, a competitive swimmer by profession, who was diagnosed with a left upper extremity thrombus. First rib resection through an infraclavicular approach was performed 1 week after percutaneous pharmacomechanical thrombectomy. Read More

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http://dx.doi.org/10.1016/j.jvscit.2019.11.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7016339PMC

Measurement of Outlet Pressures Favors Rib Resection for Decompression of Thoracic Outlet Syndrome.

Ann Thorac Surg 2020 Feb 8. Epub 2020 Feb 8.

Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, Maryland. Electronic address:

Background: When conservative therapy for thoracic outlet syndrome fails, scalenectomy with or without first-rib resection (FRR) is the treatment of choice. We measured pressure in the costoclavicular space before and after FRR at time of neurogenic thoracic outlet syndrome release to evaluate whether FRR is required to completely decompress the costoclavicular space.

Methods: Using a supraclavicular exposure for anterior-middle scalenectomy with FRR, costoclavicular space pressures were measured using a balloon catheter with the patient's arm in neutral anatomic position, secondarily, the arm abducted and externally rotated. Read More

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http://dx.doi.org/10.1016/j.athoracsur.2019.12.059DOI Listing
February 2020

Intermediate and Long-term Outcomes Following Surgical Decompression of Neurogenic Thoracic Outlet Syndrome in an Adolescent Patient Population.

Hand (N Y) 2020 Feb 10:1558944719901319. Epub 2020 Feb 10.

The University of Alabama at Birmingham, USA.

Although the diagnosis of thoracic outlet syndrome (TOS) is often missed, outcomes from surgical intervention significantly improve patient satisfaction. This article seeks to highlight patient characteristics, intraoperative findings, and both short and long-term outcomes of thoracic outlet decompression in the adolescent population. A retrospective chart review of patients between the ages of 13 and 21 years with a clinical diagnosis of neurogenic thoracic outlet syndrome (NTOS) who were treated surgically between 2000 and 2015 was performed. Read More

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http://dx.doi.org/10.1177/1558944719901319DOI Listing
February 2020

Paget-Schroetter syndrome: A contemporary review of the controversies in management.

Phlebology 2020 Feb 6:268355519898920. Epub 2020 Feb 6.

Department of Vascular Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.

Aim: To assess the current evidence, controversies and technologies behind the various approaches and steps in the management of Paget-Schroetter syndrome.

Materials And Methods: We performed a narrative review based on a literature search in Embase, Medline, Pubmed and Google Scholar through keyword searching related to upper extremity deep vein thrombosis, Paget-Schroetter syndrome and venous thoracic outlet syndrome.

Results: There is a paucity of high-quality evidence assessing the efficacy of contemporary approaches for the management of acute upper extremity deep vein thrombosis which, though promising, is largely limited to single institution case studies and small series. Read More

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http://dx.doi.org/10.1177/0268355519898920DOI Listing
February 2020
1.917 Impact Factor

Early outcomes using dedicated venous stents in the upper limb of patients with venous thoracic outlet syndrome: A single centre experience.

CVIR Endovasc 2019 Jul 18;2(1):22. Epub 2019 Jul 18.

Department of Vascular Surgery, Royal Prince Alfred Hospital, 50 Missenden Road, Camperdown, NSW, 2066, Australia.

Introduction: Surgical management of Venous Thoracic Outlet Syndrome (vTOS) is based upon resection of the first rib. The optimal method to treat any residual venous scarring however remains unclear. The purpose of this study was to evaluate a single quaternary centre's early and mid-term outcomes following endovascular reconstruction of the axillo-subclavian vein using dedicated venous stents in patients with VTOS. Read More

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http://dx.doi.org/10.1186/s42155-019-0066-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966406PMC

Computed tomography venography of the upper extremities - Using low dose bilateral contrast media injection in a patient with suspected venous thoracic outlet syndrome.

Radiol Case Rep 2020 Mar 15;15(3):302-305. Epub 2020 Jan 15.

Department of Clinical Science, Intervention and Technology at KarolinskaInstitutet, Division of Medical Imaging and Technology, Stockholm, Sweden.

Venous thoracic outflow syndrome may occur as a result from compression of the subclavian and/or axillary vein and consequently, decreased blood flow and increased risk of thrombus formation. A previously healthy 34-year-old woman who, after intensive crossfit training, experienced sudden intense pain and swelling in her right upper arm was referred for computed tomography of her right upper arm and thoracic veins. The computed tomography was performed using bilateral injection of low dose, diluted contrast medium. Read More

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http://dx.doi.org/10.1016/j.radcr.2019.12.023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6965507PMC

Surgical Anatomy of the Posterior Intermuscular Approach to the Brachial Plexus.

Hand (N Y) 2020 Jan 16:1558944719895619. Epub 2020 Jan 16.

Biruni University, Istanbul, Turkey.

First rib resection and scalenectomy is a well-established treatment option for thoracic outlet syndrome. The posterior approach is rarely used due to extensive muscle sacrifice resulting in significant procedural morbidity. In this paper, we report the surgical anatomy of modified and less-invasive muscle-sparing posterior approach. Read More

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http://dx.doi.org/10.1177/1558944719895619DOI Listing
January 2020

Comparison of transcutaneous oximetry with symptoms and arteriography in thoracic outlet syndrome.

Clin Hemorheol Microcirc 2020 Jan 6. Epub 2020 Jan 6.

UMR CNRS 6015, INSERM 1228, Medical School, University of Angers, France.

Background: Non-invasive tests are still required to improve the holistic diagnostic approach of thoracic outlet syndrome (TOS).

Objectives: We aimed to analyze the diagnostic accuracy of the decrease from rest oxygen pressure (DROP) index of transcutaneous oximetry (TcpO2) in TOS.

Methods: Seventy-six patients and 40 asymptomatic volunteers (Controls) were enrolled. Read More

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http://dx.doi.org/10.3233/CH-190751DOI Listing
January 2020

Paget-Schroetter Syndrome: a case report of diagnosis, treatment, and outcome in a healthy 18-year-old athletic swimmer.

Phys Sportsmed 2020 Feb 17:1-5. Epub 2020 Feb 17.

Primary Care Sports Medicine, University Orthopedics Center, Altoona, PA, USA.

Paget-Schroetter Syndrome is a rare condition in the spectrum of deep vein thromboses involving spontaneous upper extremity venous thrombosis in the axillary-subclavian vein. The syndrome usually occurs in young, healthy individuals and is a progressive, anatomic manifestation of venous thoracic outlet syndrome. Thrombosis is secondary to repetitive overuse of the arm, leading to compression, microtrauma, and local inflammation of the particularly vulnerable subclavian vein in the thoracic outlet at the junction of the first rib and clavicle. Read More

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http://dx.doi.org/10.1080/00913847.2019.1711236DOI Listing
February 2020