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Assessment and Treatment of Recurrent/Residual ATOS

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Thoracic Outlet Syndrome

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Abstract

Recurrent ATOS is uncommon and can be limb threatening. It can be due to several causes including failure to recognize arterial pathology when excising cervical or anomalous first ribs, failure to recognize an abnormal rib when repairing subclavian artery pathology, thrombosis of a subclavian artery or a previous arterial repair, or development of stenosis in a previously repaired subclavian artery. Patients may present with arm and hand claudication or acute upper limb ischemia caused by graft thrombosis or distal emboli. Depending on the etiology, treatment may include excision of an abnormal rib, thrombectomy or replacement of the subclavian artery or previous bypass graft, or distal embolectomy. In addition, the potential contribution of sympathetic nerves to the ischemic condition should be evaluated and addressed.

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Author information

Authors and Affiliations

  1. Department of Vascular Surgery, Vascular Institute of the Rockies, Presbyterian St. Luke’s Medical Center, 1601 East 19th Avenue, Suite 3950, Denver, CO, 80218, USA

    Stephen J. Annest MD, FACS

  2. Department of Surgery, HealthONE Presbyterian-St. Lukes Hospital, 4545 E. 9th Ave #240, Denver, CO, 80220, USA

    Richard J. Sanders MD

Authors
  1. Stephen J. Annest MD, FACS
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  2. Richard J. Sanders MD
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Corresponding author

Correspondence to Stephen J. Annest MD, FACS .

Editor information

Editors and Affiliations

  1. , Division of Vascular Surgery, University of South Florida, Tampa General Circle, STC 7016 2, Tampa, 33606, Florida, USA

    Karl A. Illig

  2. Barnes-Jewish Hospital, Department of Surgery, Washington University, Queeny Tower Campus Box, St. Louis, 63110, Missouri, USA

    Robert W. Thompson

  3. , Department of Surgery, John Hopkins Medical Institutions, Rutland Avenue - Ross 759 729, Baltimore, 21205, Maryland, USA

    Julie Ann Freischlag

  4. , Department of Thoracic Surgery, Blake 15, Massachusetts General Hospital, Fruit Street 55, Boston, 02114, Massachusetts, USA

    Dean M. Donahue

  5. Neurological Associates of West LA, Wilshire Blvd, Suite 790 2811, Santa Monica, 90403, California, USA

    Sheldon E. Jordan

  6. , Graduate Program in Physical Therapy, UCSF/SFSU, Balmoral Street 2429, Union City, 94587, California, USA

    Peter I. Edgelow

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© 2013 Springer-Verlag London

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Annest, S.J., Sanders, R.J. (2013). Assessment and Treatment of Recurrent/Residual ATOS. In: Illig, K., Thompson, R., Freischlag, J., Donahue, D., Jordan, S., Edgelow, P. (eds) Thoracic Outlet Syndrome. Springer, London. https://doi.org/10.1007/978-1-4471-4366-6_88

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  • DOI: https://doi.org/10.1007/978-1-4471-4366-6_88

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4365-9

  • Online ISBN: 978-1-4471-4366-6

  • eBook Packages: MedicineMedicine (R0)

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