Abstract

Purpose Thoracic Outlet Syndrome has been described for nearly 200 years. Its development is interesting and will be presented. A limited series from our institution is presented with emphasis on vascular complications of this problem.Methodology A Pub. Med engine search over the last 30 years using the titles thoracic outlet syndrome and first rib resection was done.106 articles were studied. Our 6 cases of vascular ramifications of thoracic outlet syndrome are presented.Results Only 1 randomised trial comparing diffferent approaches has been reported so management has been controversial. Incidence of subclavian and axillary vein thrombosis has increased. We have found the axillary approach for this condition of Paget Schroetter syndrome difficult and access made easier by using an infraclavicular or combined with a supra clavicular approach.Conclusions As this condition is uncommon most centres will have only limited experience. A combined endovascular and surgical decompression yields best results.

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