Background: This study assessed the outcome of transaxillary first and/or cervical rib resection in a unit, which has a policy of combined assessment by a neurologist and vascular surgeon.
Methods: 61 patients underwent 83 transaxillary rib resections for thoracic outlet syndrome. A retrospective case note review of these patients was undertaken. All patients completed a telephone questionnaire regarding long-term outcome.
Results: Post-operative outpatient assessment at a median of 6 months recorded 91.5% improved, of whom 61.5% were symptom-free. 61% were available for the telephone questionnaire at a median follow-up of 4 yr. 74% reported an improvement, with complete resolution in 58%. Six described temporary improvement following surgery.
Conclusion: Transaxillary rib resection is a safe and effective procedure, allowing almost two thirds of patients a return to normal activity. Combined assessment by vascular and neurological teams may help in patient selection for surgery, as well as the accurate long-term assessment of outcome.
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Division of Thoracic Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland.
Thoracic outlet syndrome (TOS) is a rare condition resulting from the compression of the brachial plexus and/or the subclavian vessels in the thoracic outlet (TO). Neurogenic TOS (NTOS) is the most common form in up to 95% of the cases, while venous TOS (VTOS) occurs in 3-5% and arterial TOS (ATOS) in 1-2% of the cases. Patients may suffer from the pathologic coexistence of arterio-venous compression in the TO called arterio-venous TOS (AVTOS) with an overlap of clinical symptoms.
View Article and Find Full Text PDFTraumatic arterial thoracic outlet syndrome after multiple rib fractures not including the first rib in Korea: a case report.
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Department of Cardiothoracic and Vascular Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
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First Rib Resection Using Videothoracoscopy in Patients With Vascular Thoracic Outlet Syndrome.
EJVES Vasc Forum
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Thoracic Surgery Department, Hospital Británico, Buenos Aires, Argentina.
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Management and outcomes of venous thoracic outlet decompression: A transition to the infraclavicular approach.
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Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA. Electronic address:
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Surgical outcomes for occluded venous thoracic outlet syndrome following transaxillary first rib resection.
J Vasc Surg Venous Lymphat Disord
September 2024
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD. Electronic address:
Objective: Surgical decompression via transaxillary first rib resection (TFRR) is often performed in patients presenting with venous thoracic outlet syndrome (VTOS). We aimed to evaluate the outcomes of TFRR based on chronicity of completely occluded axillosubclavian veins in VTOS.
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