Neurovascular Compression at the Superior Thoracic Aperture

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Abstract
3The thoracic outlet compression syndrome is a progressive and disabling affliction The patients were primarily young women with non-specific neurologic symptoms and the objective findings of decreased blood flow to the arm. The left side was more frequently involved, and a bony abnormality (either cervical rib or anomalous 1st rib) was usually present. Arterio-grams confirmed the diagnosis by demonstrating a constriction in the sub-clavian artery. Vascular complications, such as poststenotic dilatation, arterial embolization and venous thrombosis were also documented. In these 12 patients the superior thoracic aperture was enlarged by completely resecting the 1st rib through a periscapular incision. In each case lasting relief was achieved. This is the operative procedure of choice for the thoracic outlet compression syndrome.