Optimal Approach to Thoracic Outlet Syndrome: Transaxillary, Supraclavicular, or Infraclavicular

Abstract

Thoracic outlet syndrome (TOS) is not a single entity. By definition, TOS is compression of the neurovascular bundle in the thoracic outlet area eliciting symptoms in the upper extremity. The neurovascular bundle, comprising nerve, artery, and vein, gives rise to three types of TOS: neurogenic, arterial, and venous. When using the term TOS, most people are referring to the neurogenic form which comprises over 95% of all TOS patients; venous TOS makes up 3% and arterial TOS 1%. Because the optimal approach for each of the three types is different, it is important to define which type of TOS is being discussed.