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https://www.readbyqxmd.com/read/28604581/vascular-tos-creating-a-protocol-and-sticking-to-it
#1
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/28579292/current-practice-of-thoracic-outlet-decompression-surgery-in-the-united-states
#2
Elena K Rinehardt, John E Scarborough, Kyla M Bennett
BACKGROUND: Thoracic outlet syndrome (TOS) and its management are relatively controversial topics. Most of the literature reporting the outcomes of surgical decompression for TOS derives from single-center experiences. The objective of our study was to describe the current state of TOS surgery among hospitals that participate in the American College of Surgeons National Surgical Quality Improvement Program database. METHODS: Our study sample consisted of patients from the 2005 to 2014 American College of Surgeons National Surgical Quality Improvement Program database who underwent first or cervical rib resection as their index procedure and whose constellation of diagnosis and procedure codes identified them as having neurogenic, arterial, or venous TOS...
May 31, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28537129/perioperative-outcomes-of-thoracic-outlet-syndrome-surgical-repair-in-a-nationally-validated-database
#3
Besma Nejim, Husain N Alshaikh, Isibor Arhuidese, Tammam Obeid, Ying Wei Lum, Joseph Canner, Satinderjit S Locham, Mahmoud Malas
We evaluated the occurrence of thoracic outlet syndrome (TOS) and 30-day postoperative outcomes. Patients undergoing cervical/first rib resection surgery were identified in the American College of Surgeons National Surgical Quality Improvement Program database (2005-2013). Thoracic outlet syndrome types were then examined. Propensity score matching was performed to account for potential confounders; 1180 patients were explored during the study period, 1007 (85.3%) were of the neurogenic TOS (NTOS), 32 (2.7%) patients had arterial TOS (ATOS), and 141 (12...
July 2017: Angiology
https://www.readbyqxmd.com/read/28493011/mri-of-thoracic-outlet-syndrome-in-children
#4
REVIEW
Govind B Chavhan, Vaishnavi Batmanabane, Prakash Muthusami, Alexander J Towbin, Gregory H Borschel
Thoracic outlet syndrome is caused by compression of the neurovascular bundle as it passes from the upper thorax to the axilla. The neurovascular bundle can be compressed by bony structures such as the first rib, cervical ribs or bone tubercles, or from soft-tissue abnormalities like a fibrous band, muscle hypertrophy or space-occupying lesion. Thoracic outlet syndrome commonly affects young adults but can be seen in the pediatric age group, especially in older children. Diagnosis is based on a holistic approach encompassing clinical features, physical examination findings including those triggered by various maneuvers, electromyography, nerve conduction studies and imaging...
May 10, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28479443/postoperative-pain-management-following-thoracic-outlet-decompression
#5
Mathew Wooster, Dana Reed, Adam Tanious, Karl Illig
BACKGROUND: Thoracic outlet decompression (TOD) is associated with significant postoperative pain often leading to hospital length of stay out of proportion to the risk profile of the operation. We seek to describe the improvement in hospital length of stay and patient pain control with an improved multiagent pain management regimen. METHODS: We retrospectively reviewed the hospital length of stay, medication regimen/usage, operative details, and operative indications for all patients undergoing TOD from January 2012 through June 2015...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28422344/use-of-blood-pool-agents-with-steady-state-mri-to-assess-the-vascular-system
#6
Avnesh S Thakor, John Chung, Premal Patel, Anthony Chan, Amdad Ahmed, Graeme McNeil, David M Liu, Bruce Forster, Darren Klass
Over the past two decades there have been significant advances in the use of magnetic resonance imaging (MRI) to assess the vascular system. New imaging sequences and improvements in magnet design have enabled the creation of higher spatial resolution images. MRI is now a viable alternative imaging modality when compared to both invasive angiography and computed tomographic angiography. The use of blood pool agents has further facilitated the use of MR angiography (MRA); their high molecular weight allows for lower doses of contrast medium administration while their prolonged presence in the blood stream allows for repeated high-quality volumetric imaging of both the arterial and venous circulation...
April 19, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28303559/-thoracic-outlet-syndrome
#7
Sven Seifert, Pavel Sebesta, Marian Klenske, Mirko Esche
Introduction Thoracic outlet syndrome (TOS) is one of the most extensively discussed diagnoses. There is neither a clear and homogenous clinical presentation nor an accepted definition. The term describes a complex of symptoms and complaints caused by the compression of nerves and vascular structures at one of the three defined constrictions of the upper thoracic aperture. Methods Based on a comprehensive literature review, this article presents the etiology, epidemiology and clinical diagnostics as well as the possibilities and outcomes of surgical treatment...
February 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28261890/ozone-prevents-cochlear-damage-from-ischemia-reperfusion-injury-in-guinea-pigs
#8
Merih Onal, Cagdas Elsurer, Nebil Selimoglu, Mustafa Yilmaz, Ender Erdogan, Jale Bengi Celik, Oznur Kal, Ozkan Onal
The cochlea is an end organ, which is metabolically dependent on a nutrient and oxygen supply to maintain its normal physiological function. Cochlear ischemia and reperfusion (IR) injury is considered one of the most important causes of human idiopathic sudden sensorineural hearing loss. The aim of the present study was to study the efficacy of ozone therapy against cochlear damage caused by IR injury and to investigate the potential clinical use of this treatment for sudden deafness. Twenty-eight guinea pigs were randomized into four groups...
March 5, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28252318/oxidative-injury-associated-with-stenting-of-asymptomatic-carotid-artery-stenosis
#9
Erhan Saraçoğlu, Ertan Vuruşkan, Yusuf Çekici, Salih Kiliç, Halil Ay, Uğur Ergün
BACKGROUND: After carotid artery stenting (CAS), neurological complications that cannot be explained with imaging methods may develop. In our study we aimed to show, using oxidative stress markers, isolated oxidative damage and resulting neurological findings following CAS in patients with asymptomatic carotid artery stenosis. PATIENTS AND METHODS: We included 131 neurologically asymptomatic patients requiring CAS. The neurological findings were evaluated using the modified Rankin Scale (mRS) prior to the procedure, one hour post-procedure, and two days after...
March 2, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28006856/the-thoracic-outlet-syndromes-part-2-the-arterial-venous-neurovascular-and-disputed-thoracic-outlet-syndromes
#10
Mark A Ferrante, Nicole D Ferrante
The thoracic outlet syndromes (TOSs) are a group of etiologically and clinically distinct disorders with 1 feature in common: compression of 1 or more neurovascular elements as they traverse the thoracic outlet. The medical literature reflects 5 TOSs: arterial; venous; traumatic neurovascular; true neurogenic; and disputed. Of these, the first 4 demonstrate all of the features expected of a syndrome, whereas disputed TOS does not, causing many experts to doubt its existence altogether. Thus, some categorize disputed TOSs as cervicoscapular pain syndrome rather than as a type of TOS...
December 22, 2016: Muscle & Nerve
https://www.readbyqxmd.com/read/28006844/the-thoracic-outlet-syndromes-part-1-overview-of-the-thoracic-outlet-syndromes-and-review-of-true-neurogenic-thoracic-outlet-syndrome
#11
Mark A Ferrante, Nicole D Ferrante
The thoracic outlet syndromes (TOSs) are a group of etiologically and clinically distinct disorders with 1 feature in common: compression of 1 or more neurovascular elements as they traverse the thoracic outlet. The medical literature reflects 5 TOSs: arterial; venous; traumatic neurovascular; true neurogenic; and disputed. Of these, the first 4 demonstrate all of the features expected of a syndrome, whereas disputed TOS does not, causing many experts to doubt its existence altogether. Thus, some categorize disputed TOS as a cervicoscapular pain syndrome rather than as a type of TOS...
June 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/27994711/oxidant-status-following-cardiac-surgery-with-phosphorylcholine-coated-extracorporeal-circulation-systems
#12
RANDOMIZED CONTROLLED TRIAL
Ali Can Hatemi, Kadir Çeviker, Aybala Tongut, İlhan Özgöl, Murat Mert, Ayşem Kaya
Introduction. Extracorporeal circulation (ECC) related systemic oxidative stress is a well-known entity but the underlying mechanisms are not clearly described. Our aim was to investigate the relation between the oxidative stress indices, inflammatory markers, and phosphorylcholine-coated (PCC) ECC systems. Patients and Methods. Thirty-two consecutive coronary artery bypass grafting (CABG) cases were randomly assigned to Group I (PCC, n = 18) and Group II (noncoated, n = 14) ECC circuits. Total Antioxidant Status (TAS), Total Oxidant Status (TOS), Tumor Necrosis Factor-α (TNF-α), Interleukin-1β (IL-β), Interleukin-6 (IL-6), Interleukin-8 (IL-8), Interleukin-10 (IL-10), and Procalcitonin (PCT) levels were measured at 5 different time points...
2016: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/27989967/modified-interscalene-approach-for-resection-of-symptomatic-cervical-rib-anatomic-review-and-clinical-study
#13
Walid Abdel Ghany, Mohamed A Nada, Ahmed F Toubar, Ahmed E Desoky, Hesham Ibrahim, Marwa A Nassef, Mostafa G Mahran
BACKGROUND: Cervical ribs have been reported to be present in about 0.5% of the general population, 10% of patients with cervical rib who are symptomatic usually have neurogenic symptoms, but some have arterial symptoms. In 1861, Coote was the first to excise a cervical rib through a supraclavicular approach and relieved the symptoms of thoracic outlet syndrome. OBJECTIVE: In this study, we address the efficacy and safety of a modification to the supraclavicular approach for resection of symptomatic cervical ribs...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27979572/a-fourteen-year-experience-with-vascular-anomalies-encountered-during-transaxillary-rib-resection-for-thoracic-outlet-syndrome
#14
Jeniann A Yi, Robert J Johnston, Mark R Nehler, Douglas R Gibula, Kristen Alix, Natalia O Glebova, Charles O Brantigan
BACKGROUND: Transaxillary approach to first rib resection and scalenectomy (TAFRRS) is a well-established technique for treatment of thoracic outlet syndrome (TOS). Although anatomic features encountered during TAFRRS are in general constant, vascular anomalies may be encountered but have not been described to date. Herein we describe vascular abnormalities encountered during TAFRRS. METHODS: We performed a retrospective review of a prospective practice database of 224 operations for TOS performed in 172 patients from March 2000 to March 2014...
December 12, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27760981/arterial-thoracic-outlet-syndrome-rare-and-triggering
#15
Umar Sadat, Melissa Loja, Ammara Usman, Julie A Freischlag, Kevin Varty
Arterial thoracic outlet syndrome (TOS) is the least common type of TOS. Patient's symptoms, clinical examination and duplex ultrasonography usually suffice in deciding patient's management. Our proposed treatment strategies are based on the Scher classification. The choice of the procedure and approach should depend on surgeon's experience and need for arterial reconstruction.
December 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27678264/prediabetes-and-type-2-diabetes-are-associated-with-generalized-microvascular-dysfunction-the-maastricht-study
#16
MULTICENTER STUDY
Ben M Sörensen, Alfons J H M Houben, Tos T J M Berendschot, Jan S A G Schouten, Abraham A Kroon, Carla J H van der Kallen, Ronald M A Henry, Annemarie Koster, Simone J S Sep, Pieter C Dagnelie, Nicolaas C Schaper, Miranda T Schram, Coen D A Stehouwer
BACKGROUND: Type 2 diabetes (T2DM) is associated with an increased risk of cardiovascular disease. This can be partly explained by large-artery dysfunction, which already occurs in prediabetes ("ticking clock hypothesis"). Whether a similar phenomenon also applies to microvascular dysfunction is not known. We therefore tested the hypothesis that microvascular dysfunction is already present in prediabetes and is more severe in T2DM. To do so, we investigated the associations of prediabetes, T2DM, and measures of hyperglycemia with microvascular function measured as flicker light-induced retinal arteriolar dilation and heat-induced skin hyperemia...
November 1, 2016: Circulation
https://www.readbyqxmd.com/read/27668336/arterial-thoracic-outlet-syndrome-rare-and-triggering
#17
Umar Sadat, Melissa Loja, Ammara Usman, Julie A Freischlag, Kevin Varty
Arterial thoracic outlet syndrome (TOS) is the least common type of TOS. Patient's symptoms, clinical examination and duplex ultrasonography usually suffice in deciding patient's management. Our proposed treatment strategies are based on the Scher classification. The choice of the procedure and approach should depend on surgeon's experience and need for arterial reconstruction.
December 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27666803/outcome-of-surgical-treatment-for-thoracic-outlet-syndrome-systematic-review-and-meta-analysis
#18
REVIEW
Jesse Peek, Cornelis G Vos, Çağdaş Ünlü, Henricus D W M van de Pavoordt, Peter J van den Akker, Jean-Paul P M de Vries
BACKGROUND: Many publications report outcomes of surgical treatment for thoracic outlet syndrome (TOS); however, high-quality reviews and meta-analyses are lacking. This systematic review and meta-analysis summarizes and compares the outcomes and major complications of the surgical procedures for the 3 types of TOS: arterial, venous, and neurogenic. METHODS: MEDLINE, EMBASE, and CINAHL databases, and the Cochrane Database of Systematic Reviews were searched for papers published between January 1980 and February 2015, using the keywords thoracic outlet syndrome, and treatment and surgical...
April 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27659601/totally-endoscopic-vats-first-rib-resection-for-thoracic-outlet-syndrome
#19
Robert S George, Richard Milton, Nilanjan Chaudhuri, Emmanuel Kefaloyannis, Kostas Papagiannopoulos
BACKGROUND: Thoracic outlet syndrome (TOS) causes neurologic symptoms in 95% of cases and vascular symptoms in 5% of cases. Surgical resection is curative. Endoscopic-assisted transaxillary first rib resection has been previously reported. In this study we report a totally endoscopic video-assisted thoracoscopic surgery (VATS) approach using tailored endoscopic instruments. METHODS: Ten patients (8 women; average age, 32.3 ± 5.6 years) with TOS underwent VATS first rib resection following failure of symptom improvement with physiotherapy...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27568153/vascular-thoracic-outlet-syndrome
#20
REVIEW
Mohamad Anas Hussain, Badr Aljabri, Mohammed Al-Omran
Two distinct terms are used to describe vascular thoracic outlet syndrome (TOS) depending on which structure is predominantly affected: venous TOS (due to subclavian vein compression) and arterial TOS (due to subclavian artery compression). Although the venous and arterial subtypes of TOS affect only 3% and <1% of all TOS patients respectively, the diagnostic and management approaches to venous and arterial TOS have undergone considerable evolution due to the recent emergence of minimally invasive endovascular techniques such as catheter-directed arterial and venous thrombolysis, and balloon angioplasty...
2016: Seminars in Thoracic and Cardiovascular Surgery
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