Skip to main content
SpringerLink
Log in

The Thoracic Outlet Compression Syndrome

  • Chapter
Angiography of the Upper Extremity

Part of the book series: Series in Radiology ((SERA,volume 7))

  • 91 Accesses

Abstract

The term thoracic outlet compression syndrome was recommended by Rob and Standeven in 1958. It is a general term for a number of neurovascular symptoms which are attributed to compression of the brachial plexus, subclavian artery or subclavian vein in the anatomical areas of the scalene triangle, costoclavicular space and minor pectoral muscle space. Numerous terms have been used in the literature to connect these symptoms with one of the potential pressure points, such as: Scalenus Anticus Syndrome Costoclavicular Syndrome Cervical Rib Syndrome Cervical-brachial Compression Syndrome First Thoracic Rib Syndrome Hyperabduction Syndrome Pectoralis Minor Syndrome These syndromes are often extremely difficult to separate clinically. The incidence of neurovascular compression at the thoracic outlet is not known. It is predominantly seen in adults with a sex ratio of four females to one male (Parry, 1979). The symptoms generally appear after the third decade of life.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Achterberg, J. R. and J. W. Jansen van Wigmont: De betekenis van arteriografie voor de diagnostiek van het thoracic outlet syndroom. Ned. T. Geneesk. 118:1550–1554, 1974.

    PubMed  CAS  Google Scholar 

  • Adler, J. and I. Hooshmans: The Angiographic Spectrum of the Thoracic Outlet Syndrome. Clinica Radiol., 24: 35–42, 1973.

    Article  CAS  Google Scholar 

  • Adson, A. W.: Cervical ribs: Symptoms, differential diagnosis for section of the insertion of the scalenus anticus muscle. J. Int. Coll. Surg. 16:546, 1951.

    Google Scholar 

  • Adson, A. W. and E. V. Allen: Thrombosis of the Arteries of the Right Upper Extremity Resulting from Anomalous First Rib. Proc. Staff. Meet. Mayo. Clin., 13: 637–640, 1938.

    Google Scholar 

  • Allen, E. V., N. W. Barker and E. A. Hines: Peripheral vascular diseases. Ed. 3:201–224, Saunders Co. Philadelphia 1962.

    Google Scholar 

  • Baird R. J. and T. Z. Lajos: Emboli to the Arm. Am. Surg. 160:905, 1964.

    Google Scholar 

  • Conn, J. Jr.: Thoracic Outlet Syndromes. Surg. Clin. N. Amer., 54:155–164, 1974.

    PubMed  Google Scholar 

  • Coote, H: Pressure on the axillary vessels and nerve by an exostosis from a cervical rib. Interference with the circulation of the arm. Med. Times Gaz., 2:108, 1861.

    Google Scholar 

  • Cox W. A. and R. H. Buxer: First rib Resection for Thoracic Outlet Compression Syndrome. Amer. Family. Physician, 9: 140:146, 1974.

    Google Scholar 

  • Delaurentis D. A., C. C. Wolferth and P. Friedmann: Thoracic Outlet Syndrome. Angiology, 25:548–553, 1974.

    Article  PubMed  CAS  Google Scholar 

  • Dijkstra, P. F. and D. Westra: Angiographic Features of Compression of the Axillary Artery by the Musculus pectoralis minor and the Head of the Humerus in the Thoracic Outlet Compression Syndrome. Radiol. Clin. 47: 423–427, 1978.

    CAS  Google Scholar 

  • Drewes, J.: Thrombosis of the axillary-subclavian vein, in ‘Pain in shoulder and Arm’, 10:111–128. Edited by Greep et al., Martinus Nijhoff Publ., The Hague, Boston, London, 1979.

    Chapter  Google Scholar 

  • Dunant, J. H.: The diagnosis of Thoracic Outlet Syndrome, in ‘Pain in Shoulder and Arm’ 13:153–164. Edited by Greep et al., Martinus Nijhoff Publ., The Hague, Boston, London, 1979.

    Chapter  Google Scholar 

  • Eden, K. C.: The vascular complications of cervical ribs and first thoracic rib abnormalities. Brit. J. Surg. 27:111–139, 1939.

    Article  Google Scholar 

  • Etter, L. E.: Osseous abnormalities of the thoracic cage seen in fourty thousand consecutive chest photoroentgenograms. Am. J. Roentg. 51: 359–363, 1944.

    Google Scholar 

  • Falconer, M. A. and Weddel: Costoclavicular Compression of the Subclavian Artery and Vein: Relation to the scalenus anticus syndrome. Lancet, 2: 539–543, 1943.

    Article  Google Scholar 

  • Greenstone, S. M., T. B. Massell, E. C. Haringman and H.A. Raphael: The Thoracic Outlet Compression Syndrome — A reappraisal. Vascular Surg. 5:121–125, 1971.

    Article  CAS  Google Scholar 

  • Haimovici, H. and L. H. Caplan: Arterial thrombosis complicating the Thoracic Outlet Syndrome: Arteriographic Considerations. Radiology, 87: 457–459, 1966.

    Google Scholar 

  • Halsted, W. S.: An experimental study of circumscribed dilation of an artery immediately distal to a partially occluding band and its bearing on the dilation of the subclavian artery observed in certain cases of cervical rib. J. Exp. Med. 24: 271–1916.

    Google Scholar 

  • Hilton, J.: On rest and pain. 2nd. ed. William Wood and Company, New York, 1879.

    Google Scholar 

  • Holman, E. F.: The obscure physiology of poststenotic dilatation. Its relation to the development of aneurysms. J. Thorac. Surg. 28:109–1954.

    Google Scholar 

  • Janevski, B.: Angiography of the Upper Extremity, in ‘Pain in Shoulder and Arm’ 3: 25–48. Edited by Greep et al., Martinus Nijhoff Publ., The Hague, Boston, London, 1979.

    Chapter  Google Scholar 

  • Judy, K. and R. L. Heyman: Vascular complications of Thoracic Outlet Syndrome. Am. J. Surg. 123:521–531, 1972.

    Article  PubMed  CAS  Google Scholar 

  • Lang, E. K.: Arteriography and Venography in the Assessment of thoracic outlet syndromes. South. Med. J. 65: 129–136, 1972.

    Article  PubMed  CAS  Google Scholar 

  • Lang, E. K.: Arteriographic Diagnosis of Neurovascular Syndromes. J.L.S. Med. Soc., 121:196–198, 1969.

    CAS  Google Scholar 

  • Lang, E. K.: Arteriographic Diagnosis of the Thoracic Outlet Syndromes. Radiology, 84:292–303, 1965.

    Google Scholar 

  • Lemmens, H. A. J.: Raynaud-Phänomen-Asphyxia manus et digitorum; Digitus mortuus sive Digitus Moriens. itvasa, Band 6:295–299, 1977.

    CAS  Google Scholar 

  • Lemmens, H. A. J.: Costoclavicular compression and dying digits, in ‘Pain in Shoulder and Arm’: 19: 217–219. Edited by Greep et al., Martinus Nijhoff Publ., The Hague, Boston, London, 1979.

    Google Scholar 

  • Lewis, T. and G. W. Pickering: Observations upon maladies in which the blood supply to the digits causes intermittently or permanently and upon bilateral gangrene of the digits: Observations relevant to so-called Raynaud’s disease. Clin. Sci. 1: 327, 1934.

    Google Scholar 

  • Lord, J. Jr.: Thoracic Outlet Syndrome, current management. Am. Surg. 173:700, 1971.

    Google Scholar 

  • Lord, J. W. and L. M. Rosati: Neurovascular Compression syndromes of the upper extremity. Ciba Clinical symposia, 10, 35, 1958.

    Google Scholar 

  • Lord, J. W. and P. W. Stone: Pectoralis minor anatomy and anterior scalenotomy with special reference to the hyperabduction syndrome and ‘effort thrombosis’ of the subclavian vein. Circulation 13: 537, 1956.

    Google Scholar 

  • Mathes, S. J. and A. A. Salam: Subclavian artery aneurysm; sequela of thoracic outlet syndrome. Surgery, 76: 506–510, 1974.

    PubMed  CAS  Google Scholar 

  • Mulder, D. S., F. A. H. Greenwood and C. E. Brooks: Posttraumatic Thoracic Outlet Syndrome. Jour. Trauma, 13: 706–715, 1973.

    Article  CAS  Google Scholar 

  • Naffziger, H. C.: The scalenus Syndrome. Surg. Gynec. and Obst. 64:119–1937.

    Google Scholar 

  • Nelson, R. M. and R. W. Davis: Thoracic Outlet Compression Syndrome. Am. Thoracic Surg. 8: 437–451, 1969.

    Article  CAS  Google Scholar 

  • Padberg, G.: Brachialgia. Psychiat. Neurol. Neurochir. (Amst.) 67:406, 1964.

    Google Scholar 

  • Padberg, G: Brachialgia — a differential diagnosis, in ‘Pain in Shoulder and Arm’ 5: 63–72. Edited by Greep et al., Martinus Nijhoff Publ., The Hague, Boston, London, 1979.

    Google Scholar 

  • Parry, E.: Diagnosis and management of arterial lesions in relations of the outlet compression syndrome, in ‘Pain in Shoulder and Arm’ 18:211–215. Edited by Greep et al., Martinus Nijhoff Publ., The Hague, Boston, London, 1979.

    Google Scholar 

  • Poland, A.: On a case of fusiform and tubular aneurysm of the subclavian artery and its successful treatment by indirect digital compression. Medico-Chir. Trans. 52:288, 1869.

    Google Scholar 

  • Rainer, W. G., W. Vigor and J. P. Newby: Surgical treatment of thoracic outlet compression. Am. J. Surg. 116: 704–707, 1968.

    Article  PubMed  CAS  Google Scholar 

  • Raphael, M. J., F. F. R. K. H. Moazzez and D. N. Offen: Vascular Manifestations of thoracic outlet compression. Angiographic Appearances, Angiology, 25(4): 237–248, 1974.

    CAS  Google Scholar 

  • Rob, C. G. and A. Standeven: Arterial Occlusion complicating thoracic outlet compression syndrome. Brit. M. J. 2: 709, 1958.

    Google Scholar 

  • Roos, D. B. and J. C. Owens: Thoracic Outlet Syndrome. Arch. Surg. 93:71, 1966.

    Google Scholar 

  • Sadler, T. R., W. G. Rainer and G. Twombley: Thoracic Outlet Compression. Application of Positioned Arteriographic and Nerve Conduction Studies. Am. J. Surg. 130: 704–706, 1975.

    Article  PubMed  CAS  Google Scholar 

  • Schein, C. J., H. Haimovici and H. Young: Arterial Thrombosis associated with cervical ribs and surgical considerations. Surgery, 40:428, 1956.

    Google Scholar 

  • Selman, M. W., W. A. Mcalpine and H. M. Foster: The Thoracic Outlet Syndrome. The Ob. State Med. J. Sep. 908–911, 1969.

    Google Scholar 

  • Shenkin, H. A.: Cervical rib and thrombosis of the SCA. J.A.M.A., 165:335, 1957.

    Article  CAS  Google Scholar 

  • Symonds, C. P.: Two cases of thrombosis of subclavian artery with homo-lateral hemiplegia of sudden onset, probably embolic. Brain, 50:259, 1927.

    Google Scholar 

  • Telford, E. D. and S. Mottershead: Pressure at the Cervico-brachial junction. Jour. Bone and Joint. Surg. 30: 249–265, 1948.

    Google Scholar 

  • Telford, E. D. and J. S. B. Stafford: The vascular complications of cervical rib. Brit. J. Surg. 18: 557, 1937.

    Google Scholar 

  • Todd, T. W.: The arterial lesion in case of ‘cervical rib’. Jour. Anat. and Physiol. 47:250 1913.

    CAS  Google Scholar 

  • Tomsick, T. A., R. A. Ahistrand and T. M. Kissel: Thoracic Outlet Syndrome associated with rib fusion and cervicothoracic Scoliosis. J. Can. Ass. Rad. 25:211–213, 1974.

    CAS  Google Scholar 

  • Urschel, H. C., M. A. Razzuk, E. M. Krusen and J. W. Caldwell: The Technique of measuring conduction velocity for thoracic outlet syndrome, in ‘Pain in Shoulder and Arm’ 14: 165–172. Edited by Greep et al., Martinus Nijhoff publ., The Hague, Boston, London, 1979.

    Chapter  Google Scholar 

  • Urschel, H. C. Jr., D. L. Paulsen and J. J. Mcnamara: Thoracic Outlet Syndrome. Am. Thoracic Surg. 6:1, 1968.

    Google Scholar 

  • Urschel, H. C. Jr. and M. A. Razzuk: Management of the Thoracic Outlet Syndrome. N. Engl. J. Med. 286:1140–1143, 1972.

    Article  PubMed  Google Scholar 

  • Wickham, J. E. A. and P. Martin: Aneurysm of the SCA in association with cervical abnormality. Brit. J. Surg. 50: 205, 1963.

    Google Scholar 

  • Winsor, T. and R. Brow: Costoclavicular syndrome Diagnosis and treatment. J.A.M.A., 196: 697–699, 1966.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology, Sint Annadal Hospital, University of Limburg, Maastricht, The Netherlands

    Blagoja K. Janevski M. D.

Authors
  1. Blagoja K. Janevski M. D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 1982 Martinus Nijhoff Publishers, The Hague

About this chapter

Cite this chapter

Janevski, B.K. (1982). The Thoracic Outlet Compression Syndrome. In: Angiography of the Upper Extremity. Series in Radiology, vol 7. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-7594-1_9

Download citation

  • DOI: https://doi.org/10.1007/978-94-009-7594-1_9

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-009-7596-5

  • Online ISBN: 978-94-009-7594-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation