Abstract
Thoracic outlet syndrome (TOS) is a constellation of signs and symptoms caused by compression of the neurovascular structures in the thoracic outlet. TOS may be classified as either neurogenic TOS (NTOS) or vascular TOS: venous TOS (VTOS) or arterial TOS (ATOS), depending on the specific structure being affected. The basis for the surgical treatment of TOS is resection of the first rib, and it may be combined with scalenectomy or cervical rib resection. Herein, we describe a case of arterial thoracic outlet syndrome which was successfully treated with totally endoscopic video-assisted thoracoscopic surgery (VATS) first rib resection.
Highlights
The thoracic outlet includes three confined spaces extending from the cervical spine and mediastinum to the lower border of the pectoralis minor muscle
These structures include the subclavian vein, the subclavian artery, and the brachial plexus and compression of any of these structures will result in venous (VTOS), arterial (ATOS), or neurogenic (NTOS) thoracic outlet syndrome, respectively [2]
We report an arterial thoracic outlet syndrome case where totally endoscopic video-assisted thoracoscopic surgery (VATS) was successfully used with excellent result
Summary
The thoracic outlet includes three confined spaces extending from the cervical spine and mediastinum to the lower border of the pectoralis minor muscle. The term “thoracic outlet syndrome” describes compression of the neurovascular structures as they exit through the cervicothoracobrachial region. These structures include the subclavian vein, the subclavian artery, and the brachial plexus and compression of any of these structures will result in venous (VTOS), arterial (ATOS), or neurogenic (NTOS) thoracic outlet syndrome, respectively [2]. Vascular involvement occurs in 5% of cases, most commonly affecting the subclavian vein (4%) followed by the subclavian artery (1%). Both conservative approach and surgical intervention are available for thoracic outlet syndrome. We report an arterial thoracic outlet syndrome case where totally endoscopic video-assisted thoracoscopic surgery (VATS) was successfully used with excellent result
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