PT  - JOURNAL ARTICLE
AU  - Altoijry, Abdulmajeed
AU  - AlGhofili, Hesham
AU  - Iqbal, Kaisor
AU  - Altuwaijri, Talal A.
AU  - Alsheikh, Sultan
AU  - AlHamzah, Musaad
AU  - Khoujah, Elham
AU  - AbuAlnasr, Mahmoud T.
AU  - Aljabri, Badr
AU  - Al-Salman, Mussaad
TI  - Vascular thoracic outlet syndrome
AID  - 10.15537/smj.2022.43.7.20220336
DP  - 2022 Jul 01
TA  - Saudi Medical Journal
PG  - 743--750
VI  - 43
IP  - 7
4099  - http://smj.org.sa/content/43/7/743.short
4100  - http://smj.org.sa/content/43/7/743.full
SO  - Saudi Med J2022 Jul 01; 43
AB  - Objectives: To outline our experience with both arterial vascular thoracic outlet syndrome (ATOS) and venous TOS (VTOS).Methods: This was a retrospective review carried out at King Saud University Medical City, Riyadh, Saudi Arabia, from 1992-2022. All patients were diagnosed based on clinical presentation, imaging, and underwent surgical decompression solely via the supraclavicular approach. The median follow-up period was 18 months (range: 4-36 months).Results: A total of 90 limbs were diagnosed with vascular TOS in 69 patients. Females accounted for 69.6% of the patients and approximately 86.7% had ATOS. All patients were symptomatic and underwent plain thoracic inlet and cervical spine radiography, along with duplex scans in both rest and provocative positions. Total cervical rib resection was carried out in 60% of cases, while 2% had partial resection. First rib resection was carried out in 13.3% of cases and combined cervical and first rib resections were carried out in 23.3%. Vascular procedures were needed for arterial repair in 20% of cases, while venous repair were carried out in 2.2%. No recurrence or post-operative mortality had been reported. Post-operative complications were observed in 18.9% of cases.Conclusion: Careful patient selection and diagnosis using advanced, but less invasive radiological imaging coupled with adequate surgical treatment can improve the patient’s outcome.