ANGIOGRAPHIC STUDY IN THE DIAGNOSIS AND TREATMENT OF THORACIC OUTLET SYNDROME

The surgical approach to compressive syndromes of the thoracic outlet of vascular or nervous origin represents, for anatomical and historical reasons, an important issue for orthopaedic surgeons. Today’s angiographic techniques give an easy and unequivocal insight of the vascular and non-vascular (indirect) nature of the disease and, consequently, give more solid indications for surgery than before. A series of 35 cases, 21 women and 14 men with an average age of 39 years, of thoracic outlet syndrome (TOS) of vascular origin is presented here. The causes of compression were cervical rib (n=24), soft tissue anomalies (n=10) and scar tissue after clavicular fracture (n=1). During surgery, two subclavian artery aneurysms containing intraluminal thrombus and one subclavian artery occlusion were found. Presenting features of cases with arterial TOS included: hand ischaemia (n=32), transient ischaemic attack (n=3) and claudicatio or vasomotor phenomena during the arm in hyperabduction (n=3). Two patients with v...