Spectrum of thoracic outlet syndrome presentation in adolescents

Kevin Chang, Emma Graf, Kylie Davis, Jasmine Demos, Taylor Roethle, Julie Ann Freischlag

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: To study the outcomes of children with thoracic outlet syndrome (TOS) treated surgically with transaxillary first-rib resection and scalenectomy (FRRS). Design: A retrospective database review. Setting: The Johns Hopkins Medical Institutions. Patients: Patients 18 years or younger who had undergone FRRS. Interventions: All patients underwent FRRS. Patients with venous TOS underwent venography 2 weeks postoperatively. Main Outcomes Measures: For patients with venous TOS, good outcomes included patent subclavian veins. For patients with neurogenic and arterial TOS, good outcomes included relief of pain and discomfort. Results: Thirty-five adolescents, including 14 male and 21 female patients, presented with TOS. Of these, 18 had venous symptoms, 9 had neurogenic symptoms, and 8 had arterial symptoms. Seventeen of the 18 patients with venous TOS had thrombosis. At postoperative venography, 13 patients required dilation of a stenotic vein, 2 had patent veins, and 2 had chronically occluded veins. All 18 patients had patent veins, but 1 had persistent ipsilateral neurogenic symptoms. Physical therapy before FRRS had failed in all 9 patients with neurogenic TOS. Five of the 8 patients with arterial TOS presented with abnormal ribs. Two had episodes of embolization, and 1 had an occluded radial artery. None had an axillosubclavian aneurysm. All 8 patients underwent FRRS; 3 also required removal of the fused cervical rib. All 35 patients had a favorable follow-up period. Conclusions: Adolescents present more frequently with venous and arterial TOS than do adults. However, in nearly all adolescent patients, treatment with FRRS leads to a rapid return to full activity.

Original languageEnglish (US)
Pages (from-to)1383-1387
Number of pages5
JournalArchives of Surgery
Volume146
Issue number12
DOIs
StatePublished - Dec 2011
Externally publishedYes

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Thoracic Outlet Syndrome
Ribs
Veins
Phlebography
Cervical Rib
Outcome Assessment (Health Care)
Subclavian Vein
Radial Artery

ASJC Scopus subject areas

  • Surgery

Cite this

Chang, K., Graf, E., Davis, K., Demos, J., Roethle, T., & Freischlag, J. A. (2011). Spectrum of thoracic outlet syndrome presentation in adolescents. Archives of Surgery, 146(12), 1383-1387. https://doi.org/10.1001/archsurg.2011.739

Spectrum of thoracic outlet syndrome presentation in adolescents. / Chang, Kevin; Graf, Emma; Davis, Kylie; Demos, Jasmine; Roethle, Taylor; Freischlag, Julie Ann.

In: Archives of Surgery, Vol. 146, No. 12, 12.2011, p. 1383-1387.

Research output: Contribution to journalArticle

Chang, K, Graf, E, Davis, K, Demos, J, Roethle, T & Freischlag, JA 2011, 'Spectrum of thoracic outlet syndrome presentation in adolescents', Archives of Surgery, vol. 146, no. 12, pp. 1383-1387. https://doi.org/10.1001/archsurg.2011.739
Chang K, Graf E, Davis K, Demos J, Roethle T, Freischlag JA. Spectrum of thoracic outlet syndrome presentation in adolescents. Archives of Surgery. 2011 Dec;146(12):1383-1387. https://doi.org/10.1001/archsurg.2011.739
Chang, Kevin ; Graf, Emma ; Davis, Kylie ; Demos, Jasmine ; Roethle, Taylor ; Freischlag, Julie Ann. / Spectrum of thoracic outlet syndrome presentation in adolescents. In: Archives of Surgery. 2011 ; Vol. 146, No. 12. pp. 1383-1387.
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