Most cases of thoracic outlet syndrome are detected by neulogical symptoms, and most of the other symptoms are caused by arterial stenosis. It is rare for the syndrome to be recognized by venous symptoms. We report a 56-year-old woman with thoracic outlet syndrome recognized by arm swelling. She was admitted for radiation therapy of a recurrent tumor of lung cancer at the left apex. Her right arm gradually became swollen. We performed venography from the right median cubital vein because of suspected venous thrombosis. Venography revealed stenosis of the right subclavian vein at the costoclavicular space, and this finding was confirmed by helical CT. These findings strongly support our diagnosis of thoracic outlet syndrome.
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J Clin Med
January 2025
Operative Research Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy.
Thoracic outlet syndrome (TOS) is an uncommon condition defined by the compression of neurovascular structures within the thoracic outlet. When conservative management strategies fail to alleviate symptoms, surgical decompression becomes necessary. The purpose of this study is to evaluate and compare the efficacy and safety of regional anesthesia (RA) using spontaneous breathing in contrast to general anesthesia (GA) for patients undergoing surgical intervention for TOS.
View Article and Find Full Text PDFSurg Radiol Anat
January 2025
Department of Pathology, Anatomy, and Laboratory Medicine (PALM), West Virginia University School of Medicine, Morgantown, WV, 26506, USA.
The unique structure and location of the internal thoracic artery make it an ideal conduit for coronary artery bypass grafting surgery and autologous breast reconstruction. Variants with different characteristics have the potential to impact surgical success. This report presents a female body donor with a novel bilateral variation of the internal thoracic artery.
View Article and Find Full Text PDFJ Transl Med
January 2025
Division of Adolescent and Young Adult Medicine, Departments of Pediatrics, Johns Hokins University School of Medicine, 200 N. Wolfe St., Room 2077, Baltimore, MD, 21287, USA.
Background: We have noted that some adolescents and young adults with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) report difficulty with arms-overhead activities, suggestive of brachial plexus dysfunction or thoracic outlet syndrome (TOS). In the TOS literature, diagnostic maneuvers focus on the provocation of upper limb symptoms (arm fatigue and heaviness, paresthesias, neck and upper back pain), but not on elicitation of systemic symptoms.
Objectives: To estimate the proportion of patients with fatiguing illness who experience local and systemic symptoms during a common maneuver used in evaluating TOS-the elevated arm stress test (EAST).
Anat Cell Biol
January 2025
Department of Anatomy and Neurobiology, College of Medicine and Health Sciences, National University of Science and Technology, Sohar, Oman.
During dissection of a 70-year-old male donor, several anatomical variations were observed, highlighted by a bilateral variant middle scalene muscle in the superolateral thoracic wall. The variant scalene muscle was traced from the transverse processes of cervical vertebrae to the fourth rib with a pronounced fascial slip. The elongated middle scalene muscle was thick in girth and abnormally wide at its insertion (56.
View Article and Find Full Text PDFJ Surg Res
January 2025
Chief of Vascular Surgery, Director of Vascular Network Development, Aortic Program, Cardiovascular Center, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts. Electronic address:
Introduction: There is currently no consensus on the optimal surgical approach for the treatment of venous thoracic outlet syndrome (vTOS). Surgical exposures for vTOS decompression include infraclavicular (IC), supraclavicular (SC), paraclavicular (PC), and transaxillary (AX) approaches. The purpose of this study is to provide a comprehensive review of the outcomes and major complications of these four surgical techniques.
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