| Abstrakt: |
Arterial thoracic outlet syndrome (aTOS) due to subclavian arterial compression at the thoracic outlet, represents the least common type of TOS (< 1%) among the three: neurogenic (nTOS), venous (vTOS), and arterial (aTOS), and it requires surgical intervention in almost all the cases, being a constant threat to limb if remains untreated. This study analyses all aTOS patients admitted and managed at two vascular centres, over a span of 8 years. In our study, we had twenty-four limbs with arterial TOS, distributed among 23 patients (bilateral cervical rib in one), mean age of presentation was 38.85 years with male predominance. Fourteen out of 24 limbs (58.33%) had chronic, eight (33.33%) had an acute presentation and two limbs (8.34%) were asymptomatic. Rest pain was the most common symptom seen in 10 (41.67%) limbs. Complete/partial cervical rib was observed in 37.5% (9/24) and 62.5% (15/24) of cases, respectively. All patients of aTOS underwent thoracic outlet decompression (TOD): as a standalone procedure in five, combined with reinforced synthetic interposition graft in 10, and with thrombectomy by Seldinger technique using a Fogarty catheter, in eight patients. Three patients (12.5%) developed post-op complications: arm haematoma, Graft Thrombosis, and haemothorax; however, no limb loss or mortality was observed during the period of follow-up. Considering the unusual and varied presentation, limb and life-threatening complications of aTOS, early detection, and appropriate management (Open/Endovascular/Hybrid) is of paramount importance for optimal outcome. [ABSTRACT FROM AUTHOR] |
