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Thoracic Outlet Syndrome

Authors:
Seung Hwa Lee

Clinical History:

Male/38 Chief complaint : Gradually aggravated left hand coldness and sensation abnormality. ECG and 2D echo are normal.

TOS-Fig-1-A-1
TOS-FIg-1-B-2

Obstruction of 1

TOS-Fig-2-A-1
TOS-Fig-2-A-2
TOS-Fig-2-C-2

2nd and 3th digital arteries. Filling defect

TOS-Fig-3-A

Suggested to be embolus is in radial artery.

TOS-Fig-4-A-1
TOS-FIg-4-B-1
+ Figure 1

Male/38 Chief complaint : Gradually aggravated left hand coldness and sensation abnormality. ECG and 2D echo are normal.

TOS-Fig-1-A-1
TOS-FIg-1-B-2
+ Figure 2

Obstruction of 1

TOS-Fig-2-A-1
TOS-Fig-2-A-2
TOS-Fig-2-C-2
+ Figure 3

2nd and 3th digital arteries. Filling defect

TOS-Fig-3-A
+ Figure 4

Suggested to be embolus is in radial artery.

TOS-Fig-4-A-1
TOS-FIg-4-B-1

Angiogram under provocation test was confirmative diagnosis tool of thoracic outlet syndrome (TOS). However, the diagnosis could be missed under usual provocation test position. Additive provocation test could be helpful and must be performed in cases that TOS is strongly suspected. We think that lateralizaton of lesions in radial artery territory of hand is one of strong clue.