Surgical Experiences of Arterial Thoracic Outlet Syndrome (TOS)
Journal of the Korean Surgical Society
;
: 49-55, 2006.
Artículo
en Coreano
| WPRIM
| ID: wpr-210843
ABSTRACT
PURPOSE:
We wanted to investigate the clinical features and treatment results of arterial type thoracic outlet syndrome (a-TOS).METHODS:
We retrospectively reviewed the surgical treatments (n=9) of a-TOS for 6 patients (4 primary, 2 secondary, males 100%, mean age 39.6 years). For achieving thoracic outlet decompression, we performed cervical rib resection (n=6) and scalenectomy (n=7) through a supraclavicular incision. Among the primary TOS patients, 4 patients required subclavian artery (SCA) reconstruction. Arterial bypass were performed using saphenous vein grafts for 2 patients with secondary a-TOS.RESULTS:
As an underlying cause of primary a-TOS, all the patients revealed bilateral cervical ribs whereas the secondary a-TOS were caused by malunion of clavicular fractures. All the patients presented with hand ischemia resting pain in 4, cyanosis in 4, tingling sense in 4, pallor in 2 and finger tip gangrene in 2. After surgical treatment, the ischemic symptoms improved in all patients, but not to a satisfactory levels in the patients with distal arterial emboli. We experienced pneumothorax, transient phrenic nerve palsy and winged scapula as the operative complications.CONCLUSION:
To achieve better treatment outcomes, we recommend early surgical treatment before the occurrence of distal arterial embolization even in the asymptomatic patients who reveal subclavian artery abnormalities. For surgical treatment of a-TOS, the supraclavicular approach combined with infraclavicular incisions offers good exposure for achieving thoracic outlet decompression and SCA reconstructions.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Palidez
/
Parálisis
/
Nervio Frénico
/
Neumotórax
/
Vena Safena
/
Escápula
/
Arteria Subclavia
/
Síndrome del Desfiladero Torácico
/
Estudios Retrospectivos
/
Trasplantes
Tipo de estudio:
Estudio observacional
Límite:
Humanos
/
Masculino
Idioma:
Coreano
Revista:
Journal of the Korean Surgical Society
Año:
2006
Tipo del documento:
Artículo
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