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https://www.readbyqxmd.com/read/29333796/upper-extremity-deep-vein-thrombosis-symptoms-diagnosis-and-treatment
#1
REVIEW
Jaber Mustafa, Ilan Asher, Zev Sthoeger
Upper extremity deep vein thrombosis (UEDVT) is defined as thrombosis of the deep venous system (subclavian, axillary, brachial, ulnar, and radial veins), which drains the upper extremities. It can be caused by thoracic outlet anatomic obstruction, such as Paget-Schroetter syndrome, (primary) or by central intravenous catheters (secondary). UEDVT may be asymptomatic or present with acute severe pain and arm swelling. Clinical suspicion should be confirmed by diagnostic imaging procedures such as duplex ultrasound, computed tomography scan, or magnetic resonance imaging...
January 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29329197/long-term-functional-outcome-of-surgical-treatment-for-thoracic-outlet-syndrome
#2
Jesse Peek, Cornelis G Vos, Çağdas Ünlü, Michiel A Schreve, Rob H W van de Mortel, Jean-Paul P M de Vries
First rib resection for thoracic outlet syndrome (TOS) is clinically successful and safe in most patients. However, long-term functional outcomes are still insufficiently known. Long-term functional outcome was assessed using a validated questionnaire. A multicenter retrospective cohort study including all patients who underwent operations for TOS from January 2005 until December 2016. Clinical records were reviewed and the long-term functional outcome was assessed by the 11-item version of the Disability of the Arm, Shoulder, and Hand (QuickDASH) questionnaire...
January 12, 2018: Diagnostics
https://www.readbyqxmd.com/read/29301465/outcomes-following-operative-management-of-thoracic-outlet-syndrome-in-the-pediatric-patients
#3
Jesus M Matos, Lorena Gonzalez, Elias Kfoury, Angela Echeverria, Carlos F Bechara, Peter H Lin
Objectives Thoracic outlet syndrome, a condition commonly reported in adults, occurs infrequently in the pediatric population. The objective of this study was to assess the outcome of surgical interventions of thoracic outlet syndrome in pediatric patients. Methods Clinical records of all pediatric patients with thoracic outlet syndrome who underwent operative repair from 2002 to 2015 in a tertiary pediatric hospital were reviewed. Pertinent clinical variables and treatment outcomes were analyzed. Results Sixty-eight patients underwent a total of 72 thoracic outlet syndrome operations (mean age 15...
January 1, 2018: Vascular
https://www.readbyqxmd.com/read/29289365/thoracoscopic-versus-transaxillary-approach-to-first-rib-resection-in-thoracic-outlet-syndrome
#4
Henrik Nuutinen, Teemu Riekkinen, Voitto Aittola, Kimmo Mäkinen, Jussi M Kärkkäinen
BACKGROUND: This study assessed the feasibility of fully endoscopic thoracoscopic first rib resection (FRR) in the treatment of neurogenic thoracic outlet syndrome by comparing early outcomes of the thoracoscopic technique against the traditional transaxillary FRR. METHODS: Between 2009 and 2016, 60 consecutive FRRs were performed on 47 patients with neurogenic thoracic outlet syndrome (13 bilateral procedures). The first 30 procedures were performed using the traditional transaxillary technique, and the novel thoracoscopic technique was used in the next 30 operations with the same indications for operative repair...
December 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29243895/thoracic-outlet-syndrome
#5
Jari Arokoski, Jaro Karppinen, Karl-August Lindgren, Heidi Vastamäki, Martti Vastamäki, Leena Ristolainen, Katri Laimi
It is important to remember the possibility of nonspecific thoracic outlet syndrome (TOS) when treating patients with neck and upper extremity symptoms. There are no specific diagnostic criteria for the syndrome. Diagnosis is based on symptoms, clinical examination and the ruling out of other causes. The first-line option of clinical care is conservative treatment, which in most cases is sufficient for the patient to regain normal functioning. However, some of the most difficult TOS patients need surgical treatment, especially when persistent symptoms have already begun in adolescence, and if compression of neural or vascular structures is thought to result from anatomical structures...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29241462/-neurogenic-thoracic-outlet-syndrome
#6
J A W Teijink, N Pesser, R van Grinsven, H van Suijlekom, M R H M van Sambeek, B F L van Nuenen
Neurogenic thoracic outlet syndrome (nTOS) is a type of thoracic outlet syndrome (TOS) where compression of the brachial plexus is responsible for development of upper-extremity, head and neck symptoms. We present a 16-year-old and a 34-year-old patient with nTOS. Diagnosis in both cases was done by following the recently published reporting standards for (n)TOS. After this multidisciplinary diagnostic work-up we performed a transaxillary thoracic outlet decompression (TOD). Due to lack of literature, difficult nomenclature and complexity of diagnosis and treatment, diagnosis of nTOS is often delayed...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29233633/dynamic-ct-angiography-for-the-diagnosis-of-patients-with-thoracic-outlet-syndrome-correlation-with-patient-symptoms
#7
Romain Gillet, Pedro Teixeira, Jean-Baptiste Meyer, Aymeric Rauch, Ariane Raymond, François Dap, Alain Blum
INTRODUCTION: Vasculo-nervous structures serving the upper limbs may be compressed as they pass through three areas: the inter-scalene triangle (IST), the costo-clavicular space (CCS) and the retropectoralis minor space (RMS). The diagnosis of thoracic outlet syndrome (TOS) is essentially clinical, but requires imaging to specify the site of compression, its grade and the existence of predisposing anatomical factors, in order to guide the treatment and eliminate the main differential diagnoses...
December 2, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29218290/critical-upper-limb-ischemia-due-to-brachial-tourniquet-in-misdiagnosed-thoracic-outlet-syndrome-after-carpal-tunnel-decompression-a-case-report
#8
Cesare Tiengo, Andrea Monticelli, Stefano Bonvini, Valentina Wassermann, Erica Dalla Venezia, Franco Bassetto
We present the case of a 68-year-old woman, referred to our department for critical upper limb ischemia, which had occurred a few days after homolateral surgical ligamentotomy for carpal tunnel syndrome, diagnosed and confirmed by electromyography, and performed with a brachial tourniquet. The patient was later admitted for subsequent progressive necrosis of the first three fingers of the left hand, accompanied by signs of upper limb ischemia. An accessory cervical rib was identified, completely obliterating the subclavian artery distally at the origin of the suprascapular artery...
September 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29203316/cervical-rib-prevalence-and-its-association-with-thoracic-outlet-syndrome-a-meta-analysis-of-141-studies-with-surgical-considerations
#9
Brandon Michael Henry, Jens Vikse, Beatrice Sanna, Dominik Taterra, Martyna Gomulska, Przemysław A Pękala, R Shane Tubbs, Krzysztof A Tomaszewski
BACKGROUND: Cervical ribs (CR) are supernumerary ribs that arise from the seventh cervical vertebra. In the presence of CR, the boundaries of the interscalene triangle can be further constricted and result in neurovascular compression and thoracic outlet syndrome (TOS). The aim of our study was to provide a comprehensive evidence-based assessment of CR prevalence and their association with TOS as well as surgical approach to excision of CR and surgical patients' characteristics. METHODS: A thorough search of major electronic databases was conducted to identify any relevant studies...
December 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29201432/tube-construction-by-a-tanaidacean-crustacean-using-a-novel-mucus-secretion-system-involving-the-anal-opening
#10
Keiichi Kakui, Chizue Hiruta
Background: Animals in diverse aquatic groups construct tubes using mucus and filaments, and the acquisition of this capability has likely played an important role in the evolution and diversification of small benthic animals. Tanaidacea is a crustacean order that includes tube-constructing species, most of which belong to Tanaidoidea and Paratanaoidea, with a few in Kalliapseudidae (Apseudoidea). Two previously reported systems used in tube construction are the thoracic-gland system, with secretory glands in thoracic segments (pereonites), and the pereopodal-gland system, with glands in pereopods...
2017: Zoological Letters
https://www.readbyqxmd.com/read/29193950/-unicentric-castleman-s-disease-in-cervical-back-space-neck
#11
Jenny Chamorro-Oscullo, Fernando Robles-Ramírez, Jorge Valenzuela-Tamariz, Julián Antonio Sánchez-Cortázar, Guadalupe Gómez-Pérez
BACKGROUND: Castleman´s disease is a rare, benign condition of lymphoid tissue. There are two clinical types: unicentric and multicentric with three histological variants, hyaline-vascular, plasma celular and mixed. The most common sites of this are mediastinum, adbomen and neck. Magnetic resonance imaging is well suited to depict the characteristics of the masses and their relationship to adjacent structures. The knowledge of this disease and its inclusión in the differential diagnosis from other neck masses will contribute to the therapeutic approach...
September 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29170836/phase-contrast-cerebrospinal-fluid-flow-magnetic-resonance-imaging-in-qualitative-evaluation-of-patency-of-csf-flow-pathways-prior-to-infusion-of-chemotherapeutic-and-other-agents-into-the-fourth-ventricle
#12
Rajan P Patel, Clark W Sitton, Leena M Ketonen, Ping Hou, Jason M Johnson, Seferino Romo, Stephen Fletcher, Manish N Shah, Marcia Kerr, Wafik Zaky, Michael E Rytting, Soumen Khatua, David I Sandberg
PURPOSE: Nuclear medicine studies have previously been utilized to assess for blockage of cerebrospinal fluid (CSF) flow prior to intraventricular chemotherapy infusions. To assess CSF flow without nuclear medicine studies, we obtained cine phase-contrast MRI sequences that assess CSF flow from the fourth ventricle down to the sacrum. METHODS: In three clinical trials, 18 patients with recurrent malignant posterior fossa tumors underwent implantation of a ventricular access device (VAD) into the fourth ventricle, either with or without simultaneous tumor resection...
November 23, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29127878/absence-of-the-subclavius-muscle-with-contralateral-subclavius-posticus-muscle-first-imaging-report
#13
Yun Sam, Sekyoung Park, Chang Su Kim
We present a case of a 56-year-old man with pain in in his right anterior shoulder, arm, and hand. MRI studies demonstrated absence of the subclavius muscle with contralateral subclavius posticus muscle. To our knowledge, imaging of the total absence of subclavius muscle has not been previously described. Understanding and recognition of subclavius posticus muscle are important for its potential role in thoracic outlet syndrome.
October 16, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/29125442/long-term-outcomes-after-surgical-treatment-of-pediatric-neurogenic-thoracic-outlet-syndrome
#14
Jennifer Hong, Jared M Pisapia, Zarina S Ali, Austin J Heuer, Erin Alexander, Gregory G Heuer, Eric L Zager
OBJECTIVE Neurogenic thoracic outlet syndrome (nTOS) is an uncommon compression syndrome of the brachial plexus that presents with pain, sensory changes, and motor weakness in the affected limb. The authors reviewed the clinical presentations and outcomes in their series of pediatric patients with surgically treated nTOS over a 6-year period. METHODS Cases of nTOS in patients age 18 years or younger were extracted for analysis from a prospective database of peripheral nerve operations. Baseline patient characteristics, imaging and neurophysiological data, operative findings, and outcomes and complications were assessed...
November 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29112470/safety-and-efficacy-of-catheter-directed-therapies-as-a-supplement-to-surgical-decompression-in-venous-thoracic-outlet-syndrome
#15
Omar Zurkiya, Dean M Donahue, T Gregory Walker, Suvranu Ganguli
OBJECTIVE: The purpose of this study is to evaluate the role of endovascular therapy in the management of venous thoracic outlet syndrome (TOS), with an emphasis on its role after surgical decompression. MATERIALS AND METHODS: This single-center retrospective review identified all patients who underwent conventional contrast-enhanced venography as a component of the imaging evaluation of clinically suspected venous TOS from January 2004 through September 2015. Eighty-one patients were identified, with a mean (± SD) age of 33 ± 12 years, of whom 59% (48/81) were women...
November 7, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29106657/posterior-upper-rib-excision-for-neurogenic-thoracic-outlet-syndrome-feasibility-and-early-outcomes
#16
Kamran Aghayev, Ozcan Ciklatekerlio
BACKGROUND: There are several surgical treatment options for neurogenic thoracic outlet syndrome (n-TOS). However, the first rib has been shown to be the common denominator of all TOS forms and the degree of its resection has been shown to correlate with the long-term success. OBJECTIVE: To demonstrate the feasibility of posterior upper rib excision (PURE) and report early outcomes. METHODS: Nine patients presented with signs and symptoms of n-TOS...
July 6, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29058833/-upper-extremity-deep-venous-effort-thrombosis-management-of-the-paget-schroetter-syndrome-in-the-emergency-department
#17
D Ali, B Cardos
We report a case of upper extremity deep venous effort thrombosis complicating a thoracic outlet syndrome in a 44-year-old patient. The appearance of this complication was sudden. A clinical examination followed by imaging with phlebography leads to a quick diagnosis. Effort thrombosis is a classic example of an entity which, if treated correctly, has minimal long-term sequelae but, if ignored, is associated with significant long-term morbidity. An appropriate medical and interventional care has been implemented as soon as possible...
October 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28970979/all-endoscopic-brachial-plexus-complete-neurolysis-for-idiopathic-neurogenic-thoracic-outlet-syndrome-surgical-technique
#18
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
#19
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
#20
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...
December 2017: Journal of Vascular Surgery
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