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venous thoracic outlet syndrome

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https://www.readbyqxmd.com/read/27849513/venous-thoracic-outlet-syndrome-the-role-of-early-rib-resection
#1
Vienna G Katana, Jeffrey S Weiss
The upper extremity is an uncommon site for deep vein thrombosis and, although most of these thrombotic events are secondary to catheters or indwelling devices, venous thoracic outlet syndrome is an important cause of primary thrombosis. Young, active, otherwise healthy individuals that engage in repetitive upper extremity exercises, such as those required by a military vocation, may be at an increased risk. We present the case of a Naval Officer diagnosed with venous thoracic outlet syndrome whereby a multimodal approach with early surgical decompression was used...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27666803/outcome-of-surgical-treatment-for-thoracic-outlet-syndrome-systematic-review-and-meta-analysis
#2
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...
September 22, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27639006/diagnosis-and-treatment-of-effort-induced-thrombosis-of-the-axillary-subclavian-vein-due-to-venous-thoracic-outlet-syndrome
#3
REVIEW
Chandu Vemuri, Payam Salehi, Jaime Benarroch-Gampel, Lauren N McLaughlin, Robert W Thompson
Venous thoracic outlet syndrome (VTOS) is uncommon but most frequently occurs in young, active, healthy patients. This condition typically presents as subclavian vein (SCV) effort thrombosis, also known as Paget-Schroetter syndrome. The pathophysiology underlying VTOS is chronic repetitive compression injury of the SCV in the costoclavicular space, resulting in progressive venous scarring, focal stenosis, and eventual thrombosis. Clinical evaluation includes a history and physical examination followed by catheter-based venography, for definitive confirmation of the diagnosis and initial treatment with pharmacomechanical thrombolysis...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/27634612/you-re-the-flight-surgeon
#4
(no author information available yet)
Bozung TK. You're the flight surgeon: venous thoracic outlet syndrome. Aerosp Med Hum Perform. 2016; 87(8):748-751.
August 2016: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/27587803/diagnosis-of-paget-schroetter-syndrome-primary-effort-thrombosis-in-a-recreational-weight-lifter
#5
Lucia C DeLisa, Craig P Hensley, Steven Jackson
BACKGROUND AND PURPOSE: Paget-Schroetter syndrome (PSS) is a rare condition of vein thrombosis that can be manifested in athletes and laborers who overuse their upper extremities. If diagnosed early, PSS can be managed and the symptoms can be fully reversed. Venous duplex ultrasound (US), the modality most commonly used to diagnose deep vein thrombosis (DVT), has high sensitivity and specificity for detecting DVT. This case report describes the differential diagnosis and management of PSS in a weight lifter...
September 1, 2016: Physical Therapy
https://www.readbyqxmd.com/read/27568153/vascular-thoracic-outlet-syndrome
#6
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
https://www.readbyqxmd.com/read/27565607/reporting-standards-of-the-society-for-vascular-surgery-for-thoracic-outlet-syndrome
#7
Karl A Illig, Dean Donahue, Audra Duncan, Julie Freischlag, Hugh Gelabert, Kaj Johansen, Sheldon Jordan, Richard Sanders, Robert Thompson
Thoracic outlet syndrome (TOS) is a group of disorders all having in common compression at the thoracic outlet. Three structures are at risk: the brachial plexus, the subclavian vein, and the subclavian artery, producing neurogenic (NTOS), venous (VTOS), and arterial (ATOS) thoracic outlet syndromes, respectively. Each of these three are separate entities, though they can coexist and possibly overlap. The treatment of NTOS, in particular, has been hampered by lack of data, which in turn is the result of inconsistent definitions and diagnosis, uncertainty with regard to treatment options, and lack of consistent outcome measures...
September 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27565596/reporting-standards-of-the-society-for-vascular-surgery-for-thoracic-outlet-syndrome-executive-summary
#8
Karl A Illig, Dean Donahue, Audra Duncan, Julie Freischlag, Hugh Gelabert, Kaj Johansen, Sheldon Jordan, Richard Sanders, Robert Thompson
Thoracic outlet syndrome (TOS) is a group of disorders all having in common compression at the thoracic outlet. Three structures are at risk: the brachial plexus, the subclavian vein, and the subclavian artery, producing neurogenic (NTOS), venous (VTOS), and arterial (ATOS) thoracic outlet syndromes, respectively. Each of these three are separate entities, though they can coexist and possibly overlap. The treatment of NTOS, in particular, has been hampered by lack of data, which in turn is the result of inconsistent definitions and diagnosis, uncertainty with regard to treatment options, and lack of consistent outcome measures...
September 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27546594/an-unusual-cause-of-thoracic-outlet-syndrome
#9
Davide Zampieri, Giuseppe Marulli, Marco Mammana, Francesca Calabrese, Marco Schiavon, Federico Rea
Thoracic outlet syndrome (TOS) is a condition arising from compression of the subclavian vessels and/or brachial plexus. Many factors or diseases may cause compression of the neurovascular bundle at the thoracic outlet. We describe the case of a 41-year-old woman with TOS who presented with vascular venous symptoms. Chest computed tomography (CT) scan showed a cystic mass at the level of cervico-thoracic junction, located between the left subclavian artery and vein, which appeared compressed. The cystic mass was removed through a cervical approach and it was found to be a cyst arising from the thoracic duct compressing and anteriorly dislocating the left subclavian vein...
July 26, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27531080/venous-thoracic-outlet-syndrome-as-a-cause-of-intractable-migraines
#10
Veer Chahwala, Jun Tashiro, Xiaoyi Li, Atif Baqai, Jorge Rey, Handel R Robinson
Thoracic outlet syndrome (TOS) refers to the compression of the neurovascular bundle within the thoracic outlet. Cases are classified by primary etiology-arterial, neurogenic, or venous. In addition to the typical symptoms of arm swelling and paresthesias, headaches have been reported as a potential symptom of TOS. In this report, we describe a patient with debilitating migraines, which were consistently preceded by unilateral arm swelling. Resolution of symptoms occurred only after thoracic outlet decompression...
August 12, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27530880/upper-extremity-deep-venous-thrombosis-and-pulmonary-embolus-after-ovarian-hyperstimulation
#11
Anne Catherine Miller Cramer, Anna Warszawa McLean, Jalil Ahari
A healthy female presented with upper extremity (UE) swelling of several days duration. Admission laboratories were normal except for an elevated D-dimer. An UE ultrasound with Doppler revealed a thrombus in the right subclavian vein. A subsequent chest CT angiogram further characterised the subclavian vein thrombus and also identified a pulmonary embolus. A thorough history and laboratory evaluation showed that her only risk factors were long-time contraceptive pills and a recent cycle of ovarian hyperstimulation (OH) 7 weeks prior to presentation...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27525184/screening-for-referral-by-a-sports-physical-therapist-reveals-an-effort-thrombosis-in-a-collegiate-pitcher-a-case-report
#12
William R VanWye, Jase Pinerola, Karen Craig Ogle, Harvey W Wallmann
BACKGROUND AND PURPOSE: Screening for referral, regardless of setting, is the responsibility of all physical therapists. A serious condition that sports physical therapists may encounter is upper extremity (UE) deep venous thrombosis (DVT), which can result in the important and sometimes fatal complication of pulmonary embolism. CASE DESCRIPTION: A 22 year-old male right-hand dominant collegiate pitcher was referred for physical therapist evaluation and treatment secondary to acute right UE pain and swelling...
August 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27286869/combined-non-surgical-treatment-for-paget-schr%C3%A3-etter-syndrome-a-case-report
#13
Gemma Edo Fleta, Álvaro Torres Blanco, Francisco Gómez Palonés, Eduardo Ortiz Monzón
BACKGROUND: Paget-Schröetter syndrome is an uncommon form of venous thrombosis, which is related to thoracic outlet syndrome. Axillary-subclavian vein thrombosis typically presents in healthy young adults. We present this case of particular interest because it indicates that a combined treatment involving thrombolysis, anticoagulation therapy, rehabilitation, and elastic compression sleeves can be a valid non-surgical alternative for some patients with Paget-Schröetter syndrome. CASE PRESENTATION: This report describes a case of a 38-year-old white woman, a swimmer, who presented with a sudden episode of swelling and pain in her right upper extremity...
June 10, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27136755/the-diagnostic-accuracy-of-clinical-diagnostic-tests-for-thoracic-outlet-syndrome
#14
Krista M Hixson, Hannah B Horris, Tamara C Valovich McLeod, Cailee E Welch Bacon
Thoracic outlet syndrome is comprised of symptoms resulting from a compression of the neurovascular structures that pass through the intra-scalene triangle. This condition poses challenges in diagnosis due to the syndrome's vague definition, which only identifies the location of pathology without identifying which structures are specifically compromised. Thoracic outlet syndrome is categorized into vascular or neurogenic types with vascular cases subcategorized as arterial or venous and neurogenic cases subcategorized as true or disputed...
May 2, 2016: Journal of Sport Rehabilitation
https://www.readbyqxmd.com/read/26992617/infraclavicular-first-rib-resection-for-the-treatment-of-acute-venous-thoracic-outlet-syndrome
#15
Jeffrey J Siracuse, Paul C Johnston, Douglas W Jones, Heather L Gill, Peter H Connolly, Andrew J Meltzer, Darren B Schneider
OBJECTIVE: Venous thoracic outlet syndrome (VTOS) is most commonly treated by transaxillary, supraclavicular, or paraclavicular approaches, based on surgeon preference. However, we have adopted an infraclavicular approach to VTOS as the surgical pathology is in the anterior costoclavicular space. We hypothesize that this approach, combined with catheter-directed thrombolysis (CDT) with venoplasty as needed, provides safe and effective treatment of patients with an acute presentation of VTOS...
October 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/26992308/concurrent-venography-during-first-rib-resection-and-scalenectomy-for-venous-thoracic-outlet-syndrome-is-safe-and-efficient
#16
Alexander T Hawkins, Maria J Schaumeier, Ann D Smith, Marit S de Vos, Karen J Ho, Marcus E Semel, Louis L Nguyen
OBJECTIVE: Surgical treatment of acute axillosubclavian vein thrombosis from venous thoracic outlet syndrome (VTOS) traditionally involves first rib resection and scalenectomy (FRRS) followed by interval venography and balloon angioplasty. This approach can lead to an extended need for anticoagulation and a separate anesthesia session. We present outcomes for FRRS with concurrent venography. METHODS: Retrospective chart review was performed for consecutive patients undergoing FRRS with concurrent venography for VTOS from February 2007 to April 2014...
July 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/26916767/conservative-management-of-chronic-upper-extremity-venous-outflow-occlusion
#17
REVIEW
Benjamin S Brooke
Chronic upper extremity venous outflow occlusion (UEVOO) occurs frequently among hospitalized patients as a result of various anatomical or pathological etiologies. This includes venous thoracic outlet syndrome, catheter-related injury, malignancy, and hypercoagulable states. While open surgical and endovascular therapies have increasingly been utilized in managing UEVOO, many patients can still be successfully managed with non-invasive therapies. In this review, we will discuss how conservative measures such as anticoagulation and compression therapy can be applied to different causes of UEVOO...
March 2016: Phlebology
https://www.readbyqxmd.com/read/26916766/treatment-of-upper-extremity-outflow-thrombosis
#18
REVIEW
Marijn M L van den Houten, Regine van Grinsven, Sjaak Pouwels, Lonneke S F Yo, Marc R H M van Sambeek, Joep A W Teijink
Approximately 10% of all cases of deep vein thrombosis (DVT) occur in the upper extremities. The most common secondary cause of upper-extremity DVT (UEDVT) is the presence of a venous catheter. Primary UEDVT is far less common and usually occurs in patients with anatomic abnormalities of the costoclavicular space causing compression of the subclavian vein, called venous thoracic outlet syndrome (VTOS). Subsequently, movement of the arm results in repetitive microtrauma to the vein and its surrounding structures causing apparent 'spontaneous' thrombosis, or Paget-Schrötter syndrome...
March 2016: Phlebology
https://www.readbyqxmd.com/read/26780738/guidance-for-the-treatment-of-deep-vein-thrombosis-and-pulmonary-embolism
#19
REVIEW
Michael B Streiff, Giancarlo Agnelli, Jean M Connors, Mark Crowther, Sabine Eichinger, Renato Lopes, Robert D McBane, Stephan Moll, Jack Ansell
This guidance document focuses on the diagnosis and treatment of venous thromboembolism (VTE). Efficient, cost effective diagnosis of VTE is facilitated by combining medical history and physical examination with pre-test probability models, D dimer testing and selective use of confirmatory imaging. Clinical prediction rules, biomarkers and imaging can be used to tailor therapy to disease severity. Anticoagulation options for acute VTE include unfractionated heparin, low molecular weight heparin, fondaparinux and the direct oral anticoagulants (DOACs)...
January 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/26744377/preoperative-duplex-scanning-is-a-helpful-diagnostic-tool-in-neurogenic-thoracic-outlet-syndrome
#20
Megan S Orlando, Kendall C Likes, Serene Mirza, Yue Cao, Anne Cohen, Ying Wei Lum, Julie A Freischlag
OBJECTIVE: To evaluate the diagnostic role of venous and arterial duplex scanning in neurogenic thoracic outlet syndrome (NTOS). METHODS: Retrospective review of patients who underwent duplex ultrasonography prior to first rib resection and scalenectomy (FRRS) for NTOS from 2005 to 2013. Abnormal scans included ipsilateral compression (IC) with abduction of the symptomatic extremity (>50% change in subclavian vessel flow), contralateral (asymptomatic side) compression (CC) or bilateral compression (BC)...
January 2016: Vascular and Endovascular Surgery
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