Vascular thoracic outlet compression syndrome

ABSTRACT

The aim of this study was to describe our experience with the surgical treatment of arterial and venous thoracic outlet syndrome. This prospective study included 25 patients with vascular compression at thoracic outlet area. They were admitted to Vascular Surgery Unit, Mansoura University Hospital during the period from July 2004 to July 2007. Patients were classified into two main groups. Group I [arterial thoracic outlet syndrome, n = 16]. Group II [venous thoracic outlet syndrome, n = 9]. The operations of arterial reconstruction were worthwhile for all patients with excellent results in 11 patients [84.6%], only 2 patients [15.4%] developed early postoperative thrombosis which was managed by transbrachial thrombectomy. The success rate of surgical interference for venous non-thrombotic patients was 100% while conservative treatment of thrombotic patients showed success in 4 patients [57%] and failure in 3 patients [43%]. In patients with vascular compression, resection of the first rib, resection of cervical rib, scalenectomy and neurolysis of the brachial plexus are recommended in addition to vascular reconstruction. Our experience using the supraclauicular approach indicate that this is a safe route with good results and minimal risk to the patients health