Medial claviculectomy for the treatment of recalcitrant central venous stenosis of hemodialysis patients
ConclusionsMedial claviculectomy is an effective treatment of recalcitrant central venous stenosis of the thoracic outlet. Balloon angioplasty or stent or stent graft placement is often necessary after extrinsic compression is alleviated and demonstrates acceptable secondary patency rates.
Neurogenic thoracic outlet syndrome (NTOS) is a condition caused by compression of the brachial plexus serving the upper extremity. Diagnosis and therapy of NTOS remain disputed. Moreover, surgical treatment (thoracic outlet decompression) has never been researched in a randomized controlled trial. The recently published reporting standards for thoracic outlet syndrome by the Society for Vascular Surgery aim to produce consistency in diagnosis, description of treatment, and assessment of results to allow more valuable data to be reported.
Neurogenic thoracic outlet syndrome is a condition that is both complex to diagnose and to manage successfully. The aim of our study was to present our experience and outcomes of surgical management of thoracic outlet syndrome in adolescents.
CONCLUSIONS TOS can be evaluated by CE-MRA, T2-STIR-SPACE, and VIBE during a single examination, with a reduced contrast material dose. This imaging modality performs well in showing the anatomical structure of the neurovascular bundle and the cause of the compression. PMID: 31600179 [PubMed - in process]
Authors: Goeteyn J, Pesser N, van Nuenen B, van Sambeek M, Teijink J Abstract Introduction: Neurogenic Thoracic Outlet Syndrome (NTOS) is caused by compression of the brachial plexus. The clinical presentation of NTOS is characterized by symptoms of pain, paresthesia, numbness or muscle weakness in the neck, arm or hand. Methods: In this case report, five patients were diagnosed with NTOS. They all had a first degree relative with NTOS as well. Conlusions: These cases show familial predisposition in thoracic outlet syndrome. Could a form of familial TOS exist? PMID: 31587610 [PubMed - as supplied by publisher]
To determine if surgical decompression for vascular thoracic outlet syndrome (TOS) outweighs the risks.
Rib resection in venous thoracic outlet syndrome (VTOS) may be approached via a transaxillary, supraclavicular, or infraclavicular approach based on surgeon preference. The purpose of this study was to evaluate long-term postoperative quality of life function after surgery for VTOS and to determine if there were long term patency differences associated with the surgical approach or whether prophylactic post-operative venography was performed
Rib resection in venous thoracic outlet syndrome (vTOS) may be approached via a transaxillary, supraclavicular, or infraclavicular approach based on surgeon preference. The purpose of this study was to evaluate long-term postoperative quality of life function after surgery for vTOS and to determine if there were long-term patency differences associated with the surgical approach or whether prophylactic postoperative venography was performed.
No validated scales exist specifically for measuring quality of life (QoL) and functioning level in patients with thoracic outlet syndrome (TOS). This cross-sectional survey examined whether some items adopted from validated QoL scales could be suitable for patients with TOS.
We report our evolving experience with the treatment of acute VTOS.MethodsWe reviewed our prospectively maintained database to identify patients treated for VTOS. Our strategy includes CDT with pharmacomechanical thrombectomy, IC first rib resection during the same hospitalization, and subclavian vein angioplasty immediately after rib resection. Postoperatively, a sequential compression device was applied to the affected arm and low-dose heparin given through the ipsilateral venous sheath. Antiplatelet therapy was given for 6 weeks and anticoagulation for 6 months. Our strategy evolved from a PC to an IC approach...
The optimal surgical approach and treatment algorithm for thoracic outlet syndrome (TOS) remain controversial. We sought to examine the outcomes of patients treated at a military medical treatment facility (MTF) for TOS.