Preoperative Duplex Scanning is a Helpful Diagnostic Tool in Neurogenic Thoracic Outlet Syndrome

2016 ◽  
Vol 50 (1) ◽  
pp. 29-32 ◽  
Author(s):  
Megan S. Orlando ◽  
Kendall C. Likes ◽  
Serene Mirza ◽  
Yue Cao ◽  
Anne Cohen ◽  
...  
Keyword(s):  
Diagnostic Tool ◽  
Thoracic Outlet Syndrome ◽  
Duplex Scanning ◽  
Neurogenic Thoracic Outlet Syndrome

scholarly journals Subclavian Vessel Compression Assessed by Duplex Scanning in Patients with Neurogenic Thoracic Outlet Syndrome and No Vascular Signs

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 126
Author(s):  
Alban Fouasson-Chailloux ◽  
Pierre Menu ◽  
Pauline Daley ◽  
Giovanni Gautier ◽  
Guillaume Gadbled ◽  
...  
Keyword(s):  
Blood Flow ◽  
Thoracic Outlet Syndrome ◽  
Duplex Scanning ◽  
Vascular Compression ◽  
Upper Limbs ◽  
Frequent Form ◽  
Neurogenic Thoracic Outlet Syndrome ◽  
Significant Difference ◽  
Subclavian Vessel ◽  
Unilateral Group

Neurogenic thoracic outlet syndrome (NTOS) is the most frequent form of TOS. It may affect both sides, but specific complementary exams are lacking. We aimed to evaluate duplex scanning results in a group of patients with unilateral or bilateral NTOS and no clinical vascular signs, referred for rehabilitation. We performed a retrospective observational study in patients with unilateral or bilateral NTOS and no vascular symptoms. Subclavian vessels were assessed by duplex scanning. Compressions were considered in case of >50% of increased or decreased blood flow. A total of 101 patients met NTOS criteria; mean age was 40 +/− 10.2; 79.2% women. Seventy patients had a unilateral NTOS and 31 a bilateral form. Duplex scanning showed that 56.4% of the patients had vessels compression, 55.7% in the unilateral group and 58.1% in the bilateral (p = 0.81). In unilateral NTOS, 21 (30%) patients had bilateral vascular compression, 17 (24.3%) had ipsilateral compression and 1 (1.4%) had contralateral compression. In bilateral NTOS, 15 (48.4%) had bilateral compression and 3 (9.7%) compression on only one side. We found a significant difference of the rate of vascular compressions between symptomatic and non-symptomatic upper-limbs, 54.5% vs. 32.9%, respectively, (p = 0.002) and a significant association between symptomatic upper-limbs and vascular compression (OR = 2.45 [95%IC: 1.33–4.49]; p = 0.002). The sensitivity and the specificity of the duplex scanning were 54.5% and 67%, respectively. The ROC curve area was of 0.608 [95%IC: 0.527–0.690]. Despite a highly significant association between symptomatic upper-limbs and vascular compression, duplex scanning did not help make the diagnosis of NTOS.

scholarly journals Computed tomography-guided reoperation for neurogenic thoracic outlet syndrome

2015 ◽  
Vol 61 (2) ◽  
pp. 469-474 ◽  
Author(s):  
Joshua I. Greenberg ◽  
Kristen Alix ◽  
Mark R. Nehler ◽  
Robert J. Johnston ◽  
Charles O. Brantigan
Keyword(s):  
Computed Tomography ◽  
Thoracic Outlet Syndrome ◽  
Neurogenic Thoracic Outlet Syndrome

Diagnosis of Neurogenic Thoracic Outlet Syndrome Based on the Clinical Status

2021 ◽  
Author(s):  
Ji Sup Hwang ◽  
Jihyeung Kim ◽  
Shin Kim ◽  
Kee Jeong Bae ◽  
Yohan Lee ◽  
...  
Keyword(s):  
Thoracic Outlet Syndrome ◽  
Clinical Status ◽  
Neurogenic Thoracic Outlet Syndrome

Anatomically Complete Supraclavicular Reoperation for Recurrent Neurogenic Thoracic Outlet Syndrome: Clinical Characteristics, Operative Findings, and Long-term Outcomes

Hand ◽  
2021 ◽  
pp. 155894472098807
Author(s):  
Momodou L. Jammeh ◽  
J. Westley Ohman ◽  
Chandu Vemuri ◽  
Ahmmad A. Abuirqeba ◽  
Robert W. Thompson
Keyword(s):  
Thoracic Outlet Syndrome ◽  
Length Of Hospital Stay ◽  
Functional Improvement ◽  
Scalene Muscle ◽  
Neurogenic Thoracic Outlet Syndrome ◽  
First Rib ◽  
Previous Operation ◽  
Combined Operations ◽  
The Mean ◽  
Operative Findings

Background: The clinical outcomes of reoperations for recurrent neurogenic thoracic outlet syndrome (NTOS) remain undefined. Methods: From 2009 to 2019, 90 patients with recurrent NTOS underwent anatomically complete supraclavicular reoperation after previous operation(s) performed at other institutions using either supraclavicular (Prev-SC = 48), transaxillary (Prev-TA = 31), or multiple/combination (Prev-MC = 11) approaches. Prospectively maintained data were analyzed retrospectively. Results: The mean patient age was 39.9 ± 1.4 years, 72% were female, and the mean interval after previous operation was 4.1 ± 0.6 years. The mean Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score was 62 ± 2, reflecting substantial preoperative disability. Residual scalene muscle was present in 100% Prev-TA, 79% Prev-SC, and 55% Prev-MC ( P < .05). Retained/residual first rib was present in 90% Prev-TA, 75% Prev-SC, and 55% Prev-MC ( P < .05). There were no differences in operative time (overall 210 ± 5 minutes), length of hospital stay (4.7 ± 0.2 days), or 30-day readmissions (7%). During follow-up of 5.6 ± 0.3 years, the improvement in QuickDASH scores was 21 ± 2 (36% ± 3%) ( P < .01) and patient-rated outcomes were excellent in 10%, good in 36%, fair in 43%, and poor in 11%. Conclusions: Anatomically complete decompression for recurrent NTOS can be safely and effectively accomplished by supraclavicular reoperation, regardless of the type of previous operation. Residual scalene muscle and retained/residual first rib are more frequently encountered after transaxillary operations than after supraclavicular or multiple/combined operations. Supraclavicular reoperation can achieve significant symptom reduction and functional improvement for approximately 90% of patients with recurrent NTOS.

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