The thoracic outlet is a small area between your collarbone, first rib and vertebra. Thoracic outlet syndrome (TOS) is a group of conditions characterized by compression of the nerves, arteries or veins in this space. Thoracic outlet syndrome can cause neck and shoulder pain, numbness and tingling of the fingers and a weak grip. If left untreated, TOS can lead to increased pain and decreased function. Certain forms of the disease can cause serious blood clots.
Thoracic outlet syndrome can be difficult to diagnose as its symptoms can mimic other disorders. Expert vascular specialists in the Division of Vascular and Endovascular Surgery at the Brigham and Women’s Hospital (BWH) Heart & Vascular Center provide specialized diagnostic services to identify TOS as well as proven medical and surgical techniques to relieve symptoms.
There are three types of thoracic outlet syndrome (TOS):
Symptoms of TOS vary depending upon whether the compression is nerve, artery or vein-related.
Nerve-related thoracic outlet syndrome
Vein or artery-related thoracic outlet syndrome
Your vascular surgeon will often work in conjunction with a neurologist to evaluate your symptoms. A physical examination will be conducted to determine outward signs of TOS such as discoloration or swelling. Diagnostic tests may include:
Specialists from the BWH Heart and Vascular Center develop individualized treatment plans for patients based on:
Specific treatment varies depending on the type of TOS and may include:
The Heart & Vascular Center is located in the Shapiro Cardiovascular Center, across the street from BWH’s main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of services in one location, fostering seamless and coordinated care for all cardiovascular patients.
If you are having surgery or a procedure, you will likely be scheduled for a visit to the Watkins Clinic for pre-operative information and tests.
The day of surgery, you care will be provided by surgeons, anesthesiologists and nurses who specialize in surgery for patients with thoracic outlet syndrome. After surgery, you will go to the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.
During your surgery, family and friends can wait in the Shapiro Family Center. Staff members will provide surgery updates and caregivers who leave the hospital will be contacted by cell phone.
Patients benefit from the teamwork of vascular and endovascular surgeons who collaborate with colleagues in other medical specialties. They work alongside nurses, physician assistants, physical therapists, dietitians and social workers to achieve outstanding outcomes for our patients.
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