Clinical presentation and management of arterial thoracic outlet syndrome.

Objective: Arterial thoracic outlet syndrome (TOS) is a rare condition characterized by subclavian artery pathology associated with a bony abnormality. This study assessed contemporary clinical management of arterial TOS at a high-volume referral center.

Methods: A prospectively maintained database was used to conduct a retrospective review of patients undergoing primary or reoperative treatment for arterial TOS during an 8-year period (2008 to 2016).

Diagnosis and treatment of effort-induced thrombosis of the axillary subclavian vein due to venous thoracic outlet syndrome.

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.

The supraclavius muscle is a novel muscular anomaly observed in two cases of thoracic outlet syndrome.

Various anomalous muscles and fibrofascial structures have been described in relation to the anatomy of thoracic outlet syndrome. We describe two patients with a previously undescribed muscle anomaly, which originated laterally near the trapezius muscle, coursed across the supraclavicular space deep to the scalene fat pad, and attached obliquely to the superior undersurface of the medial clavicle, which we have termed the "supraclavius" muscle. The significance of the supraclavius muscle is unknown, but its occurrence in patients with thoracic outlet syndrome indicates that it can be associated with narrowing of the anatomic space adjacent to the neurovascular structures.