ACR Appropriateness Criteria® Thoracic Outlet Syndrome

Zurkiya, Omar; Ganguli, Suvranu; Kalva, Sanjeeva P.; Chung, Jonathan H.; Shah, Lubdha M.; Majdalany, Bill S.; Bykowski, Julie; Carter, Brett W.; Chandra, Ankur; Collins, Jeremy D.; Gunn, Andrew J.; Kendi, Ayse T.; Khaja, Minhajuddin S.; Liebeskind, David S; Maldonado, Fabien; Obara, Piotr; Sutphin, Patrick D.; Tong, Betty C.; Vijay, Kanupriya; Corey, Amanda S.; Kanne, Jeffrey P.; Dill, Karin E.

doi:10.1016/j.jacr.2020.01.029

Cited by 17 publications

(16 citation statements)

References 37 publications

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“…In that way, symptoms and clinical findings specific to particular structures of the neurovascular bundle justify further investigations in order to diagnose TOS ( 4 , 5 , 8 ). A combination of high level of suspicion, thorough clinical examination and understanding of the syndrome is essential in order to arrange and interpret further clinical investigations ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

Thoracic Outlet Syndrome: Single Center Experience on Robotic Assisted First Rib Resection and Literature Review

et al. 2022

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BackgroundThoracic outlet syndrome (TOS) is a pathological condition caused by a narrowing between the clavicle and first rib leading to a compression of the neurovascular bundle to the upper extremity. The incidence of TOS is probably nowadays underestimated because the diagnosis could be very challenging without a thorough clinical examination along with appropriate clinical testing. Beside traditional supra-, infraclavicular or transaxillary approaches, the robotic assisted first rib resection has been gaining importance in the last few years.MethodsWe conducted a retrospective cohort analysis of all patients who underwent robotic assisted first rib resection due to TOS at Lucerne Cantonal Hospital and then we performed a narrative review of the English literature using PubMed, Cochrane Database of Systematic Reviews and Scopus.ResultsBetween June 2020 and November 2021, eleven robotic assisted first rib resections were performed due to TOS at Lucerne Cantonal Hospital. Median length of stay was 2 days (Standard Deviation: +/– 0.67 days). Median surgery time was 180 min (Standard Deviation: +/– 36.5). No intra-operative complications were reported.ConclusionsRobotic assisted first rib resection could represent a safe and feasible option in expert hands for the treatment of thoracic outlet syndrome.

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Section: Discussionmentioning

confidence: 99%

Thoracic Outlet Syndrome: Single Center Experience on Robotic Assisted First Rib Resection and Literature Review

et al. 2022

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“…Although the combination of patient history and detailed physical exam often induce strong clinical suspicion of TOS, imaging is often necessary to confirm both the subtype and exact anatomical site of compression. Plain chest radiographs play a significant role in the diagnosis of all three types of TOS and serve as good initial tests, especially if the clinical presentation is vague [46,48]. Chest X-rays are also useful in identifying bony abnormalities associated with TOS, including cervical ribs, first rib anomalies, focal bone lesions, and congenital malformations [28,48].…”

Section: Imaging and Additional Diagnostic Testsmentioning

confidence: 99%

“…Plain chest radiographs play a significant role in the diagnosis of all three types of TOS and serve as good initial tests, especially if the clinical presentation is vague [46,48]. Chest X-rays are also useful in identifying bony abnormalities associated with TOS, including cervical ribs, first rib anomalies, focal bone lesions, and congenital malformations [28,48]. CT and MRI also play definitive roles in diagnosing TOS subtypes by providing a more detailed survey of the anatomy [46].…”

Section: Imaging and Additional Diagnostic Testsmentioning

confidence: 99%

“…Regarding vTOS and aTOS, duplex ultrasound (DUS) is used to detect subclavian vessel aneurysm, as it is readily available, noninvasive, and can be used during dynamic maneuvers [32,48]. If surgery is not indicated, DUSs may be repeated every six months in asymptomatic aTOS patients for continual monitoring [32].…”

Section: Diminished or Absent Radial Pulsementioning

confidence: 99%

“…Venography is considered a mainstay of vTOS diagnosis, and may be combined with intravascular ultrasound to evaluate external vessel compression in vTOS patients with a negative DUS [32]. CT and MR angiography and venography are reliable diagnostic tools that can also identify dynamic changes with positioning and have been deemed appropriate in the diagnosis of aTOS and vTOS by the American College of Radiology [48]. See Table 3 for a summary of imaging studies.…”

Section: Diminished or Absent Radial Pulsementioning

confidence: 99%

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Thoracic Outlet Syndrome: A Narrative Review

Dierks

Vervaeke

et al. 2021

JCM

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Thoracic outlet syndrome comprises a group of disorders that result in compression of the brachial plexus and subclavian vessels exiting the thoracic outlet. Symptoms include pain, paresthesia, pallor, and weakness depending upon the compromised structures. While consensus in diagnostic criteria has not yet been established, a thorough patient history, physical exam, and appropriate imaging studies are helpful in diagnosis. General first-line therapy for thoracic outlet syndrome is a conservative treatment, and may include physical therapy, lifestyle modifications, NSAIDs, and injection therapy of botulinum toxin A or steroids. Patients who have failed conservative therapy are considered for surgical decompression. This article aims to review the epidemiology, etiology, relevant anatomy, clinical presentations, diagnosis, and management of thoracic outlet syndrome.

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Thoracic-Outlet-Syndrome

Debus,

Grundmann

2023

Evidence-Based Therapy in Vascular Surgery

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ACR Appropriateness Criteria® Thoracic Outlet Syndrome

Cited by 17 publications

References 37 publications

Thoracic Outlet Syndrome: Single Center Experience on Robotic Assisted First Rib Resection and Literature Review

Thoracic Outlet Syndrome: Single Center Experience on Robotic Assisted First Rib Resection and Literature Review

Thoracic Outlet Syndrome: A Narrative Review

Thoracic-Outlet-Syndrome

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