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This relatively large single-institution series demonstrates the diverse clinical presentation of arterial TOS coincident with a spectrum of bony and arterial pathology. Current surgical protocols can achieve excellent outcomes for this rare and often complicated condition.

mortality rate of 3.6%). Four patients (4.7%) developed postoperative seizures. There was no myocardial infarction, permanent cranial nerve palsy, or re-exploration for neck hematoma. Demographics, clinical presentation, and complications are shown in Table . Conclusions: Early CEA in patients with mild to moderate stroke does not result in increased perioperative stroke/death or seizure compared with delayed CEA and therefore should be preferred to enhance secondary stroke prevention.

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.