Thoracic Outlet Syndrome

Compression of Neurovascular bundle at the Thoracic outlet leading to upper limb symptoms like pain, discoloration of fingers or swelling in the neck. Incidence is 0.5 to 1.5% in general population of which 68% are seen in women. It is mainly due to an extra rib in the neck or a band which leads to compression. It is called Scalenus Anticus Syndrome if associated with a band.

Types

Neurogenic leading to compression of brachial plexus
Vascular causing arterial or venous compression

Investigations

Presentation

Pain and tingling in the fingers if due to compression
Bluish discolouration of fingers if due to embolus or arterial occlussion
Neck swelling due to rib or subclavian artery aneurysm

Treatment

Mainly surgical
Anterior and middle scalenectomy
1st rib resection
Cervical rib or band resection
Vascular reconstruction & revascularization e.g. subclavian artery aneurysm surgery

Dr. Pankaj Patel a vascular surgeon has expertise in peripheral vascular diseases, varicose veins and deep vein thrombosis