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Thoracic outlet syndrome

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https://www.readbyqxmd.com/read/28970979/all-endoscopic-brachial-plexus-complete-neurolysis-for-idiopathic-neurogenic-thoracic-outlet-syndrome-surgical-technique
#1
Thibault Lafosse, Malo Le Hanneur, Laurent Lafosse
Neurogenic thoracic outlet syndrome is caused by a neurologic compression of the brachial plexus before it reaches the arm. Three anatomic areas are common locations for such an entrapment because of their congenital and/or acquired tightness: the interscalene triangle, the costoclavicular space, and the retropectoralis minor space. Because the compression level usually remains unknown, the treatment is still controversial and most teams focus on only one potential site. We propose an all-endoscopic technique of complete brachial plexus neurolysis that can be divided into three parts, one for each entrapment area...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28943489/frequency-of-the-pectoralis-minor-compression-syndrome-in-patients-treated-for-thoracic-outlet-syndrome
#2
Myriam Ammi, Matthieu Péret, Samir Henni, Mickaël Daligault, Pierre Abraham, Xavier Papon, Bernard Enon, Jean Picquet
BACKGROUND: Pectoralis minor compression syndrome (PMCS) is a compression of the neurovascular structures in the sub-pectoral tunnel and remains underestimated in the management of patients with thoracic outlet syndrome (TOS). Its underdiagnosis may be responsible for incomplete or failed treatment. The aim of the study was to evaluate the frequency of PMCS in our experience. METHOD: We retrospectively reviewed all patients treated for TOS in our department. We selected those in whom PMCS was diagnosed with a systematic dynamic arteriography...
September 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28943009/midterm-and-long-term-follow-up-in-competitive-athletes-undergoing-thoracic-outlet-decompression-for-neurogenic-thoracic-outlet-syndrome
#3
William Shutze, Brad Richardson, Ryan Shutze, Kimberly Tran, Allen Dao, Gerald O Ogola, Allan Young, Greg Pearl
BACKGROUND: Neurogenic thoracic outlet syndrome (NTOS) results from compression of the brachial plexus by the clavicle, first rib, and scalene muscles and may develop secondary to repetitive motion of the upper extremity. Athletes routinely perform repetitive motions, and sports requiring significant arm and shoulder use may put the participant at increased risk for NTOS. Competitive athletes who develop NTOS may require first rib resection and scalenectomy (FRRS) for symptomatic relief...
September 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28928918/arterial-thoracic-outlet-syndrome-secondary-to-hypertrophy-of-the-anterior-scalene-muscle
#4
Erion Qaja, Sara Honari, Robert Rhee
Thoracic outlet syndrome (TOS) was first introduced in literature by Peet et al. in 1956. Since then is has been studied extensively and subcategorized into at least four closely related syndrome. Neurogenic TOS due to the compression of brachial plexus, arterial TOS in cases of compression of the subclavian artery, venous TOS in cases of compression of the subclavian vein, and non-specific type of TOS. Neurogenic TOS is by far the most common consisting of 95% of the cases, followed by venous and lastly arterial...
August 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28887261/stenting-of-subclavian-artery-true-and-false-aneurysms-a-systematic-review
#5
REVIEW
Anastasios Maskanakis, Nikolaos Patelis, Demetrios Moris, Diamantis I Tsilimigras, Dimitrios Schizas, Maria Diakomi, Chris Bakoyiannis, Sotirios Georgopoulos, Chris Klonaris, Theodoros Liakakos
BACKGROUND: Aneurysms of the subclavian artery are usually the result of trauma, atherosclerosis, or thoracic outlet syndrome. Until the 90s, open surgical repair was considered the only therapeutic choice, exhibiting high complication rates. Since the first report of endovascular repair of subclavian aneurysms in 1991, promising results have been published. The aim of this review was to summarize all available data on subclavian artery (SA) true and false aneurysm stenting to reach conclusions regarding morbidity, mortality, and other procedure-related characteristics...
September 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28883228/paget-schroetter-syndrome-resulting-from-thoracic-outlet-syndrome-and-kaatsu-training
#6
Tatsunori Noto, Go Hashimoto, Takahito Takagi, Toru Awaya, Tadashi Araki, Masanori Shiba, Raisuke Iijima, Hidehiko Hara, Masao Moroi, Masato Nakamura, Kaoru Sugi
A 29-year-old woman who worked as a KAATSU (a type of body exercise that involves blood flow restriction) instructor visited our emergency room with a chief complaint of swelling and left upper limb pain. Chest computed tomography (CT) showed non-uniform contrast images corresponding to the site from the left axillary vein to the left subclavian vein; vascular ultrasonography of the upper limb revealed a thrombotic obstruction at the same site, leading to a diagnosis of Paget-Schroetter syndrome (PSS). We herein report our experience with a case of PSS derived from thoracic outlet syndrome (TOS), in a patient who was a KAATSU instructor...
October 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28845317/arterial-thoracic-outlet-syndrome-treated-successfully-with-totally-endoscopic-first-rib-resection
#7
Sofoklis Mitsos, Davide Patrini, Sara Velo, Achilleas Antonopoulos, Martin Hayward, Robert S George, David Lawrence, Nikolaos Panagiotopoulos
Thoracic outlet syndrome (TOS) is a constellation of signs and symptoms caused by compression of the neurovascular structures in the thoracic outlet. TOS may be classified as either neurogenic TOS (NTOS) or vascular TOS: venous TOS (VTOS) or arterial TOS (ATOS), depending on the specific structure being affected. The basis for the surgical treatment of TOS is resection of the first rib, and it may be combined with scalenectomy or cervical rib resection. Herein, we describe a case of arterial thoracic outlet syndrome which was successfully treated with totally endoscopic video-assisted thoracoscopic surgery (VATS) first rib resection...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28840002/video-assisted-thoracoscopic-surgery-for-intrathoracic-first-rib-resection-in-thoracic-outlet-syndrome
#8
Jinwook Hwang, Byung-Ju Min, Won-Min Jo, Jae Seung Shin
BACKGROUND: First rib resection is a surgical treatment for decompressing the neurovascular structures in thoracic outlet syndrome (TOS). Historically, extrathoracic approaches have used a posterior, supraclavicular, or transaxillary incision to remove the first rib. In this report, we demonstrate video-assisted thoracoscopic surgery for intrathoracic first rib resection (VATS-IFRR). METHODS: Between 2009 and 2014, eight patients underwent VATS-IFRR for TOS. Surgery was performed through two 5-mm ports and one 10-mm port...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28768671/paget-schroetter-syndrome-complicated-by-an-incidental-pulmonary-embolism
#9
Jakub Kaczynski, Joseph Sathiananthan
A young man presented with the severe right upper limb swelling following a heavy weight lifting that was thought to be caused by a biceps tendon rupture. However, subsequent investigations confirmed the diagnosis of Paget-Schroetter syndrome that was associated with an incidental pulmonary embolism. The patient underwent a successful thrombolysis followed by a surgical thoracic outlet decompression. Overall, the patient has made a good recovery.
August 2, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28735950/associations-between-clinical-diagnostic-criteria-and-pretreatment-patient-reported-outcomes-measures-in-a-prospective-observational-cohort-of-patients-with-neurogenic-thoracic-outlet-syndrome
#10
Joshua Balderman, Katherine Holzem, Beverly J Field, Michael M Bottros, Ahmmad A Abuirqeba, Chandu Vemuri, Robert W Thompson
OBJECTIVE: Neurogenic thoracic outlet syndrome (NTOS) is caused by dynamic compression of the brachial plexus at the level of the supraclavicular scalene triangle or the subcoracoid (pectoralis minor) space, or both. The purpose of this study was to characterize relationships between 14 clinical diagnostic criteria (CDC) and seven pretreatment patient-reported outcomes measures (PROMs) in a prospective cohort of patients with NTOS. METHODS: There were 183 new patient referrals between July 1 and December 31, 2015, with 150 (82%) meeting an established set of predefined CDC for NTOS...
August 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28701678/paget-schroetter-syndrome-in-a-baseball-pitcher
#11
Shusuke Yagi, Minoru Mitsugi, Teruaki Sangawa, Masashi Akaike, Masataka Sata
Paget-Schroetter syndrome (PSS) is thrombosis of the deep veins draining the upper extremity due to anatomic abnormalities of the thoracic outlet that cause subclavian compression and subsequent thrombosis, leading to thrombus formation in the subclavian vein. Vigorous arm activity in sports is a known risk factor. Here, we report a case of Paget-Schroetter syndrome in a 31-year-old male non-professional baseball pitcher.
August 3, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28677632/ultrasonographic-diagnosis-of-thoracic-outlet-syndrome-secondary-to-brachial-plexus-piercing-variation
#12
Vanessa Leonhard, Gregory Caldwell, Mei Goh, Sean Reeder, Heather F Smith
Structural variations of the thoracic outlet create a unique risk for neurogenic thoracic outlet syndrome (nTOS) that is difficult to diagnose clinically. Common anatomical variations in brachial plexus (BP) branching were recently discovered in which portions of the proximal plexus pierce the anterior scalene. This results in possible impingement of BP nerves within the muscle belly and, therefore, predisposition for nTOS. We hypothesized that some cases of disputed nTOS result from these BP branching variants...
July 4, 2017: Diagnostics
https://www.readbyqxmd.com/read/28662867/thoracic-outlet-syndrome-after-the-nuss-procedure-for-pectus-excavatum-is-it-a-rare-complication
#13
Tomohisa Nagasao, Tadaaki Morotomi, Motone Kuriyama, Tetsukuni Kogure, Hirro Kudo, Yusuke Hamamoto, Motoki Tamai
OBJECTIVE: The present study aims to elucidate the frequency of thoracic outlet syndrome after the Nuss procedure for pectus excavatum and the conditions in which thoracic outlet syndrome is likely to develop. METHODS: A retrospective study including 85 pectus excavatum patients (58 males and 27 females) was conducted. Thoracic outlet syndrome was defined as a condition in which the patient has numbness, lassitude, or pain of the upper limbs at rest or during motion of the upper limbs...
October 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28644402/choosing-surgery-for-neurogenic-tos-the-roles-of-physical-exam-physical-therapy-and-imaging
#14
REVIEW
David P Kuwayama, Jason R Lund, Charles O Brantigan, Natalia O Glebova
Neurogenic thoracic outlet syndrome (nTOS) is characterized by arm and hand pain, paresthesias, and sometimes weakness resulting from compression of the brachial plexus within the thoracic outlet. While it is the most common subtype of TOS, nTOS can be difficult to diagnose. Furthermore, patient selection for surgical treatment can be challenging as symptoms may be vague and ambiguous, and diagnostic studies may be equivocal. Herein, we describe some approaches to aid in identifying patients who would be expected to benefit from surgical intervention for nTOS...
June 23, 2017: Diagnostics
https://www.readbyqxmd.com/read/28629121/creating-a-registry-for-patients-with-thoracic-outlet-syndrome
#15
Misty D Humphries
The creation of any patient database requires substantial planning. In the case of thoracic outlet syndrome, which is a rare disease, the Society for Vascular Surgery has defined reporting standards to serve as an outline for the creation of a patient registry. Prior to undertaking this task, it is critical that designers understand the basics of registry planning and a priori establish plans for data collection and analysis.
June 17, 2017: Diagnostics
https://www.readbyqxmd.com/read/28624897/corrosion-of-harrington-rod-in-idiopathic-scoliosis-long-term-effects
#16
Beth Sherman, Tanya Crowell
PURPOSE: Metal implants have been used to treat adolescent idiopathic scoliosis since the 1960s. Only recently, however, it has the issue of metal-bone breakdown secondary to metal corrosion in situ come to light, raising concerns of possible long-term complications from the resulting metallosis and inflammation of spinal tissues. We present a case of a patient with neurological deficit, pain, and disability with Harrington rod in place for over 30 years, to bring attention to the issue of bio-corrosion of metal implants and its effect on human tissue...
June 17, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28616159/thoracic-outlet-syndrome-as-a-consequence-of-isolated-atraumatic-first-rib-fracture
#17
Aleem K Mirza, Audra A Duncan
Neurogenic thoracic outlet syndrome (nTOS) resulting from an isolated first rib fracture is extremely infrequent. We report a case of performance limiting nTOS in a college athlete who was initially evaluated and treated for upper extremity ligamentous injury with only transient improvement. Subsequent noninvasive studies were consistent with TOS physiology and MRA showed a large hypertrophic callus on the first rib adjacent to the brachial plexus. With continued athletic limitations and radiographic findings consistent with TOS, surgical decompression was performed resulting in resolution of symptoms...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28614274/corrective-osteotomy-for-symptomatic-clavicle-malunion-using-patient-specific-osteotomy-and-reduction-guides
#18
Mathias Haefeli, Matthias Schenkel, Ralf Schumacher, Karim Eid
Midshaft clavicular fractures are often treated nonoperatively with good reported clinical outcome in a majority of patients. However, malunion with shortening of the affected clavicle is not uncommon. Shortening of the clavicle has been shown to affect shoulder strength and kinematics with alteration of scapular position. Whereas the exact clinical impact of these factors is unknown, the deformity may lead to cosmetic and functional impairment as for example pain with weight-bearing on the shoulder girdle...
September 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28604581/vascular-tos-creating-a-protocol-and-sticking-to-it
#19
REVIEW
Meena Archie, David Rigberg
Thoracic Outlet Syndrome (TOS) describes a set of disorders that arise from compression of the neurovascular structures that exit the thorax and enter the upper extremity. This can present as one of three subtypes: neurogenic, venous, or arterial. The objective of this section is to outline our current practice at a single, high-volume institution for venous and arterial TOS. VTOS: Patients who present within two weeks of acute deep vein thrombosis (DVT) are treated with anticoagulation, venography, and thrombolysis...
June 10, 2017: Diagnostics
https://www.readbyqxmd.com/read/28594492/thoracic-outlet-syndrome-getting-it-right-so-you-don-t-have-to-do-it-again
#20
Alan J Micev, Joshua M Abzug, A Lee Osterman
Thoracic outlet syndrome is a disorder caused by thoracic outlet compression of the brachial plexus and/or the subclavian vessels. The characteristics of thoracic outlet syndrome are highly variable. Objective tests, such as electrodiagnostic studies, are often unreliable in characterizing thoracic outlet syndrome. The existence of thoracic outlet syndrome as a discrete entity is controversial. Surgeons who accept the existence of thoracic outlet syndrome acknowledge that diagnosis is clinical. The variability and complexity of thoracic outlet syndrome lends itself to mistakes in both diagnosis and surgical treatment...
February 15, 2017: Instructional Course Lectures
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