How I do it. Thoracic outlet syndrome and the transaxillary approach

Matthew Vuoncino; Misty D Humphries

doi:10.1016/j.jvscit.2023.101128

How I do it. Thoracic outlet syndrome and the transaxillary approach

J Vasc Surg Cases Innov Tech. 2023 Mar 23;9(2):101128. doi: 10.1016/j.jvscit.2023.101128. eCollection 2023 Jun.

Authors

Matthew Vuoncino¹, Misty D Humphries¹

Affiliation

¹ Division of Vascular Surgery, Department of Surgery, University of California Davis Health, Sacramento, CA.

Abstract

Thoracic outlet syndrome (TOS) is a disease pattern that involves compression of neurologic venous or arterial structures as they pass through the thoracic outlet. TOS was first described as a vascular complication arising from the presence of a cervical rib. Over time, a better understanding of TOS has led to its wide range of presenting symptoms being divided into three distinct groups: arterial, venous, and neurogenic. Of the known cases, the current estimates of the incidence of neurogenic TOS, venous TOS, and arterial TOS are 95%, 3%, and 1%, respectively. The different types of TOS have completely different presentations, requiring expertise in the diagnosis, management, and treatment unique to each. We present our evaluation, diagnosis, and management method of TOS patients, with specific attention paid to the transaxillary approach.

Keywords: Axillosubclavian thrombosis; Cervical ribs; Paget-Schroetter syndrome; Subclavian vein thrombosis; Thoracic outlet syndrome.