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Thoracic Outlet Syndrome


Thoracic Outlet Syndrome (TOS) is a condition in which there is compression or pressure on the nerves and blood vessels at the top of the thoracic (chest) cavity. The syndrome can present with a number of different signs and symptoms, but most who suffer complain of persistent pain. 


Drs. Samuel Ahn and Robert Feldtman of DFW Vascular are experts in the diagnosis and treatment of this condition and recently shared new research in this field to other vascular surgeons attending the 2013 Society for Vascular Surgery (SVS). Their work, performed in conjunction with their collaborators, evaluated how blockages in the internal jugular vein play a role in this condition. The authors studied just under 250 patients for over a 4-year period and analyzed the data to look for relationships between this jugular vein blockage and the condition. The authors reported that internal jugular vein blockage is common in these patients and may contribute to their symptoms. Importantly, the authors also stated that patients experienced temporary benefits in symptoms after using catheter-based balloons to inflate the areas of blockage. In the pictures below, one can see a few key points of this important research.


    1. This drawing shows the anatomy of the thoracic outlet and notes the compression of key structures.

    2. Using dye being photographed through the veins, one can see where blockage occurs.​


    3. Using special catheters, a balloon is inflated at the site of compression (Left with blockage, right post balloon                  expansion)


​    4. Compression of the internal jugular vein is common in TOS and balloon expansion may help with symptoms.



Further work on the causes and treatment of TOS will continue in an effort to bring relief to the patients suffering from this condition. 


If you have persistent arm and neck pain, or suffer from persistent headaches, call DFW Vascular today and set up an appointment to meet with one of their surgeons. A straight-forward, office-based (outpatient) procedure may be the solution to years of pain and discomfort.

Click here for more information on TOS from the Society for Vascular Surgery, or view Dr. Feldtman’s presentation.

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