Long Term Quality of Life Comparison between Supra and Infraclavicular Rib Resection in Patients with vTOS
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
ConclusionsDuplex ultrasound has significant limitations in the initial evaluation of patients with suspected SCV thrombosis, with false-negative results in 21% of patients with proven VTOS. This is rarely acknowledged in ultrasound reports, but false-negative ultrasound studies have the potential to delay definitive imaging, thrombolysis, and further treatment for VTOS. Initial false-negative ultrasound results are associated with progressive thrombus extension and a more frequent need for SCV bypass reconstruction at the time of surgical treatment.Graphical Abstract
ConclusionMRI can contribute to the diagnosis of TOS. Specificity is sufficiently high to provide guidance for planning the surgical procedure. Sensitivity, however, is too low for MRI to be useful as a screening test. MRI should be used in combination with the clinical assessment and other investigations to assist in the diagnosis of TOS.Level of evidenceIV, retrospective cohort study.
Condition: Thoracic Outlet Syndrome Intervention: Other: non interventionnal study Sponsor: Nantes University Hospital Not yet recruiting
Upper extremity deep vein thrombosis (DVT) results from pathologic compression of the subclavian vein at the costoclavicular junction.1-3 Also known as Paget-Schroetter syndrome, this pathology is associated with high morbidity and severe symptoms.2-5 The military population is particularly susceptible given the prevalence of young, healthy service members performing rigorous physical activity and training. Our group has previously reported significant functional recovery following supraclavicular decompression for neurogenic thoracic outlet syndrome (NTOS) in the high-performance military population.
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]