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Search Results for : Thoracic Outlet Syndrome
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Thoracic outlet syndrome due to an axillary band: what if it ruptures?
Author(s): Oz; çakar, L; Carli, AB; G; örür, R; Durmu; ş, O; Kiralp, MZ
Journal: Rheumatol Int 2009 Dec 17; Vol. 30, Issue 11; Page(s) 1551-2
[Medline ID - 20013268]

ABSTRACT NOT AVAILABLE

Acute digital ischemia: a neglected microsurgical emergency. Report of 17 patients and literature review.
Author(s): Lecl; ère, FM; Mordon, S; Schoofs, M
Journal: Microsurgery 2010 Jun 10; Vol. 30, Issue 3; Page(s) 207-13
[Medline ID - 19967763]

This study was performed to review our 16-year experience in acute finger ischemia. A review of the literature was also performed. A retrospective chart review of 17 patients, 14 men and 3 women, was conducted. Etiologies were ulnar aneurysm in 11 cases, atrial fibrillation in five cases and thoracic outlet syndrome in one case. Upto the palmar superficial arch, embolus due to atrial fibrillation or thoracic outlet syndrome could be loosened by a Fogarty catheter. In cases of aneurysm of the ulnar artery, we performed each time an aneurysm resection followed by direct anastomose alone, while three patients had additional grafts: artery graft (epigastric artery) or reversed vein grafts (superficial forearm vein). Microsurgical dissection of the digital collateral arteries enabled us to perform a thrombectomy. The transversal arteriotomies were closed after the collateral arteries were washed. The immediate perfusion of digit after the reconstruction of the aneurysm was each time excellent. The disoccluded vessels, investigated by Allen testing and Doppler ultrasound, were all patents. Two patients suffered from a small ulcer of the small fingertip that disappeared after 2 weeks. One patient had a 30 degrees ischemic flexion contracture in the metacarpophalangeal joint and 25 degrees flexion contracture in the proximal interphalangeal joint of the third digit. With regards to long-term outcomes, no secondary amputations were necessary and there was no recurrence after a mean follow-up of 10.7 years. Diagnostic of acute digital ischemia is often neglected. An early recognition and an aggressive microsurgical treatment are necessary to ensure low morbidity.

Surgical treatment of thoracic outlet syndrome secondary to clavicular malunion.
Author(s): Yoo, MJ; Seo, JB; Kim, JP; Lee, JH
Journal: Clin Orthop Surg 2009 Nov 4; Vol. 1, Issue 1; Page(s) 54-7
[Medline ID - 19884998]

According to the literature, thoracic outlet syndrome (TOS) secondary to the malunion of displaced fractures of the clavicle is rare. Various surgical methods, including simple neurolysis, resection of the first rib or clavicle and corrective osteotomy, have been reported. We report a case of TOS secondary to malunion of the clavicle that was treated by an anterior and middle scalenectomy without a rib resection.

The management of thoracic inlet syndrome associated with Hurler's syndrome: a novel surgical technique.
Author(s): Ahsan, RM; Early, SA; O'Meara, A; N; ölke, L
Journal: Eur J Cardiothorac Surg 2010 Mar 17; Vol. 36, Issue 6; Page(s) 1081-3
[Medline ID - 19864154]

A 21-year-old male developed significant swelling of his tongue after a respiratory arrest. The patient had a history of Hurler's syndrome. Magnetic resonance imaging (MRI) angiogram delineated that the swelling was due to compression of his internal jugular veins at the level of the first rib, resulting in thoracic inlet obstruction. The standard surgical treatment of thoracic inlet obstruction was not suitable in this patient's case due to his short thick neck and his characteristic Hurler's syndrome body habitus. Therefore, a novel surgical strategy was used to decompress his head and neck vessels. The manubrium was widened using an iliac crest bone graft, stabilised using internal fixation plates and reconstructed with a pectoral muscle flap.

Pediatric extremity multidetector computed tomographic angiography findings.
Author(s): Oguz, B; Karcaaltincaba, M; Hazirolan, T; Leblecioglu, G; Haliloglu, M
Journal: J Comput Assist Tomogr 2009 Nov 3; Vol. 33, Issue 5; Page(s) 770-5
[Medline ID - 19820509]

OBJECTIVES: To show results of pediatric extremity multidetector computed tomographic (MDCT) angiography studies and to demonstrate diagnostic imaging findings in pediatric patients. METHODS: Multidetector computed tomographic angiography studies were performed in 20 patients using 16- and 64-row MDCT scanners. Three-dimensional volume-rendered and maxim um-intensity projection images were obtained from axial images to display vascular structures. RESULTS: All MDCT examinations were technically satisfactory. Metallic implants were present in 3 patients, and angiographic examinations were diagnostic in these patients. Occlusion, stenosis, and pseudoaneurysm were diagnosed in patients with trauma (n = 10). Vascular invasion was diagnosed in 1 patient with osteosarcoma. Compared with pathologic examination results, the sensitivity and specificity of MDCT to detect vascular invasion (n = 3) were both 100%. Three patients with vascular malformation underwent computed tomographic angiography to assess vascular supply of vascular malformations. Computed tomographic angiography showed vascular anatomy in 2 patients with congenital anomalies before and after flap transposition and in 1 patient with suspected thoracic outlet syndrome. Computed tomographic angiography showed brachial artery occlusion in a patient with Blalock-Taussing shunt. CONCLUSIONS: Multidetector computed tomographic angiography is a noninvasive technique that could replace conventional angiography as the initial diagnostic study for vascular evaluation of extremities in pediatric patients.

MR imaging findings in brachial plexopathy with thoracic outlet syndrome.
Author(s): Aralasmak, A; Karaali, K; Cevikol, C; Uysal, H; Senol, U
Journal: AJNR Am J Neuroradiol 2010 Jun 11; Vol. 31, Issue 3; Page(s) 410-7
[Medline ID - 19815618]

The BPL is a part of the peripheral nervous system. Many disease processes affect the BPL. In this article, on the basis of 60 patients, we reviewed MR imaging findings of subjects with brachial plexopathy. Different varieties of BPL lesions are discussed.

[Thoracic outlet syndromes]
Author(s): Gilbert, A
Journal: Neurochirurgie 2009 Dec 16; Vol. 55, Issue 4-5; Page(s) 432-6
[Medline ID - 19800643]

Thoracic outlet syndromes (TOS) may induce neurologic signs, vascular pathology, and pain, but the clinical signs are often unclear. The relationship between a cervical bony abnormality is often unclear, and the investigations not always contributive. First-line treatment consists in physiotherapy. Surgery remains controversial, in both its indication as its modalities. However, well-adapted surgery gives a good result in 60-85% of cases.

Index of suspicion.
Author(s): George, RP; Bocchini, JA; Smith, HD; Shah, A; Becton, JL; McDonough, C
Journal: Pediatr Rev 2010 Jan 19; Vol. 30, Issue 10; Page(s) 403-8; discussion 408
[Medline ID - 19797484]

ABSTRACT NOT AVAILABLE

Thoracic outlet syndrome in a patient with Poland syndrome.
Author(s): Oz; çakar, L; Cakar, E; Kiralp, MZ; Carli, AB; Durmu; ş, O; Din; çer, U
Journal: Ann Thorac Surg 2009 Oct 9; Vol. 88, Issue 4; Page(s) 1354-6
[Medline ID - 19766845]

We report a 20-year-old man with Poland syndrome who suffered from weakness, pain, numbness, and discoloration in the left upper extremity. He was eventually diagnosed as also having thoracic outlet syndrome. The concomitance of these two disorders is discussed with a special emphasis on the underlying mechanisms.

Thoracic outlet syndrome: do we have clinical tests as predictors for the outcome after surgery?
Author(s): Sadeghi-Azandaryani, M; B; ürklein, D; Ozimek, A; Geiger, C; Mendl, N; Steckmeier, B; Heyn, J
Journal: Eur J Med Res 2009 Nov 17; Vol. 14, Issue 10; Page(s) 443-6
[Medline ID - 19748851]

OBJECTIVE: Thoracic outlet syndrome (TOS) is a clinical phenomenon resulting from compression of the neurovascular structures at the superior aperture of the thorax which presents with varying symptoms. Regarding to the varying symptoms, the diagnosis of TOS seems to be a challenge and predictors for the outcome are rare. The purpose of this study was therefore to analyze the different clinical examinations and tests relative to their prediction of the clinical outcome subsequent to surgery. METHODS: During a period of five years, 56 patients were diagnosed with TOS. Medical history, clinical tests, operative procedure and complications were recorded and analysed. Mean follow-up of the patients was 55.6 +/- 45.5 months, median age of the patients was 36.4 +/- 12.5 years. RESULTS: Different clinical tests for TOS showed an acceptable sensitivity overall, but a poor specificity. A positive test was not associated with a poor outcome. Analyses of the systolic blood pressure before and after exercise showed, that a distinct decrease in blood pressure of the affected side after exercises was associated with a poor outcome (p = 0.0027). CONCLUSIONS: Clinical tests for TOS show a good sensitivity, but a poor specificity and cannot be used as predictors for the outcome. A distinct decrease in blood pressure of the affected side after exercises was associated with poor outcome and might be useful to predict the patients' outcome.
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