VASCULAR SURGERY
Thoracic Outlet Syndrome : First Rib Resection
Baylor Hamilton Heart and Vascular Hospital is one of the nation ’ s leading treatment centers for thoracic outlet syndrome ( TOS ) – a condition where the nerve , artery , and vein between the lower neck and upper chest become compressed , causing pain , numbness , and weakness in the upper extremity . This space is called the thoracic outlet .
Patients who suffer with daily disabling symptoms secondary to TOS are offered relief with “ First Rib Resection ,” surgical procedure , treatment offered as a part of the Vascular Program at Baylor Hamilton Heart and Vascular Hospital .
213
Total
Number of TOS Surgeries
( FY17 )
TOS occurs due to compression , injury , or irritation of the nerves and blood vessels in the thoracic outlet , located in the lower neck and upper chest area . TOS can severely inhibit the quality of life , often leading to pain , numbness , tingling and weakness in the arm , chest or neck resulting from pressure in the neck .
Reasons for the narrowing of this thoracic space vary . A patient born with an extra rib or a very narrow space may experience symptoms of TOS . Overuse of the shoulders and arms may also lead to symptoms of TOS including poor posture . Whiplash injury to the back or neck , sleep disorders , even stress or depression can increase the risk of developing TOS . Some types of this condition may become more severe , resulting in aneurysms and blood clots .
Courtesy of Cleveland Clinic Center for Medical Art and Photography
Baylor Hamilton Heart and Vascular Hospital is a nationally recognized treatment center for TOS .
MEASURING INNOVATION IN HEART AND VASCULAR CARE
Types of TOS disorders and related symptoms treated by vascular surgeons on the medical staff at Baylor Hamilton Heart and Vascular Hospital include neurogenic thoracic outlet syndrome , venous thoracic outlet syndrome , and arterial thoracic outlet syndrome . Diagnostic tests to diagnose thoracic outlet syndrome include nerve conduction studies , vascular studies , chest X-rays , cervical spine X-rays , CT and MRI of the chest or spine , arteriograms / venograms , and blood tests .
The First Rib Resection procedure involves removing part of the first rib , eliminating the pressure on the thoracic outlet . In some cases , blood vessels around the area will need to be rerouted ; if the vessels are extremely narrowed , angioplasty may become an option .
Vascular surgeons on the medical staff at Baylor Hamilton Heart and Vascular Hospital perform a large volume of TOS procedures annually , seeing patients referred from across the U . S . First rib resection frequently results in a successful return to full activity .
“ Although TOS affects men and women of all ages , it is more common among high performance athletes who participate in activities that require repetitive motions of the arm and shoulder including baseball , swimming , volleyball , and other sports . This repetitive movement can lead to the injury of the muscle or the development of scar tissue that may compress the neurovascular bundle leading into the arm form the neck and chest .”
Gregory Pearl , MD , FACS *
Medical Director , Vascular Surgery – Baylor Hamilton Heart and Vascular Hospital ; Co-Chair , Vascular Surgery
Section – Baylor University Medical Center at Dallas
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