Seminars in Vascular Surgery最新文献_第4页

Neurogenic thoracic outlet syndrome and controversies in diagnosis and management 神经源性胸廓出口综合征和诊断/管理方面的争议

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.semvascsurg.2024.02.002

Erin McIntosh , Ramesh K. Tripathi , J. Westley Ohman

{"title":"Neurogenic thoracic outlet syndrome and controversies in diagnosis and management","authors":"Erin McIntosh , Ramesh K. Tripathi , J. Westley Ohman","doi":"10.1053/j.semvascsurg.2024.02.002","DOIUrl":"10.1053/j.semvascsurg.2024.02.002","url":null,"abstract":"<div><p>Compression of the neurovascular structures at the level of the scalene triangle and pectoralis minor space is rare, but increasing awareness and understanding is allowing for the treatment of more individuals than in the past. We outlined the recognition, preoperative evaluation, and treatment of patients with neurogenic thoracic outlet syndrome. Recent work has illustrated the role of imaging and centrality of the physical examination on the diagnosis. However, a fuller understanding of the spatial biomechanics of the shoulder, scalene triangle, and pectoralis minor musculotendinous complex has shown that, although physical therapy is a mainstay of treatment, a poor response to physical therapy with a sound diagnosis should not preclude decompression. Modes of failure of surgical decompression stress the importance of full resection of the anterior scalene muscle and all posterior rib impinging elements to minimize the risk of recurrence of symptoms. Neurogenic thoracic outlet syndrome is a rare but critical cause of disability of the upper extremity. Modern understanding of the pathophysiology and evaluation have led to a sounder diagnosis. Although physical therapy is a mainstay, surgical decompression remains the gold standard to preserve and recover function of the upper extremity. Understanding these principles will be central to further developments in the treatment of this patient population.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0895796724000085/pdfft?md5=507694d0dfd52fd9d6eeb9df752d6ff6&pid=1-s2.0-S0895796724000085-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139924808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current concepts in clinical features and diagnosis of thoracic outlet syndrome 胸廓出口综合征临床特征和诊断的最新概念

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.semvascsurg.2024.01.005

Alexis Betancourt , Ehsan Benrashid , Prem Chand Gupta , Katharine L. McGinigle

引用次数: 0

Trans-axillary thoracic outlet decompression 经腋窝胸廓出口减压术

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.semvascsurg.2024.02.006

Jens Goeteyn , Stijn B.J. Teijink , Niels Pesser , Marc R.H.M. van Sambeek , Bart F.L. van Nuenen , Joep A.W. Teijink

引用次数: 0

Diagnosis and management of thoracic outlet syndrome in athletes 运动员胸廓出口综合征的诊断和治疗

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.semvascsurg.2024.01.007

Andrea T. Fisher, Jason T. Lee

{"title":"Diagnosis and management of thoracic outlet syndrome in athletes","authors":"Andrea T. Fisher, Jason T. Lee","doi":"10.1053/j.semvascsurg.2024.01.007","DOIUrl":"10.1053/j.semvascsurg.2024.01.007","url":null,"abstract":"<div><p>The physical demands of sports can place patients at elevated risk of use-related pathologies, including thoracic outlet syndrome (TOS). Overhead athletes in particular (eg, baseball and football players, swimmers, divers, and weightlifters) often subject their subclavian vessels and brachial plexuses to repetitive trauma, resulting in venous effort thrombosis, arterial occlusions, brachial plexopathy, and more. This patient population is at higher risk for Paget-Schroetter syndrome, or effort thrombosis, although neurogenic TOS (nTOS) is still the predominant form of the disease among all groups. First-rib resection is almost always recommended for vascular TOS in a young, active population, although a surgical benefit for patients with nTOS is less clear. Practitioners specializing in upper extremity disorders should take care to differentiate TOS from other repetitive use–related disorders, including shoulder orthopedic injuries and nerve entrapments at other areas of the neck and arm, as TOS is usually a diagnosis of exclusion. For nTOS, physical therapy is a cornerstone of diagnosis, along with response to injections. Most patients first undergo some period of nonoperative management with intense physical therapy and training before proceeding with rib resection. It is particularly essential for ensuring that athletes can return to their baselines of flexibility, strength, and stamina in the upper extremity. Botulinum toxin and lidocaine injections in the anterior scalene muscle might predict which patients will likely benefit from first-rib resection. Athletes are usually satisfied with their decisions to undergo first-rib resection, although the risk of rare but potentially career- or life-threatening complications, such as brachial plexus injury or subclavian vessel injury, must be considered. Frequently, they are able to return to the same or a higher level of play after full recovery.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139670275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of thoracic outlet syndrome in patients with hemodialysis access 血液透析通路患者胸廓出口综合征的处理方法

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.semvascsurg.2024.01.004

Arash Fereydooni, Michael David Sgroi

引用次数: 0

Video-assisted thoracic surgery and robotic-assisted first-rib excision and thoracic outlet syndrome decompression VATS 和机器人辅助第一肋骨切除术和 TOS 减压术

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.semvascsurg.2024.02.003

Whitney Sutton , John O'Neill , Eric Strother , Danielle A. Grossman , Ann E. Hwalek , Marc Margolis

{"title":"Video-assisted thoracic surgery and robotic-assisted first-rib excision and thoracic outlet syndrome decompression","authors":"Whitney Sutton , John O'Neill , Eric Strother , Danielle A. Grossman , Ann E. Hwalek , Marc Margolis","doi":"10.1053/j.semvascsurg.2024.02.003","DOIUrl":"10.1053/j.semvascsurg.2024.02.003","url":null,"abstract":"<div><p>Multiple surgical approaches have been used in the management of thoracic outlet syndrome. These approaches have traditionally been “open” approaches and have been associated with the inherent morbidities of an open approach, including a risk of injury to the neurovascular structures due to traction and trauma while resecting the first rib. In addition, there has been concern that recurrence of symptoms may be related to incomplete resection of the rib with conventional open techniques. With the advent of minimally invasive thoracic surgery, surgeons began to explore first-rib resection via a thoracoscopic approach. Unfortunately, the existing video-assisted thoracic surgery technology and equipment was not well suited to working in the apex of the chest. With the introduction and subsequent progress in robotic surgery and instrumentation, this dissection can be performed with all the advantages of robotics, but also with minimal traction and trauma to the neurovascular structures, and incorporates almost complete resection of the rib with minimal residual stump. Robotics has developed as a reliable, safe, and less invasive approach to first-rib resection, yielding excellent results while limiting the morbidity of the procedure.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139928075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The supraclavicular approach to decompression of the thoracic outlet 锁骨上入路胸廓出口减压术

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.semvascsurg.2024.01.006

Prem Chand Gupta , Prajna B. Kota , Vamsikrishna Yerramsetty , Velladuraichi Boologapandian , Viswanath Atreyapurapu , Pritee Sharma , Ajay Savlania

引用次数: 0

Introduction and history of thoracic outlet syndrome 胸廓出口综合征简介和病史

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.semvascsurg.2024.02.005

Anahita Dua , Ramesh K. Tripathi

引用次数: 0

Systematic review of intermediate and long-term results of thoracic outlet decompression 胸廓出口减压术中期和长期效果的系统回顾

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.semvascsurg.2024.01.001

Mitri K. Khoury, Micah A. Thornton, Anahita Dua

{"title":"Systematic review of intermediate and long-term results of thoracic outlet decompression","authors":"Mitri K. Khoury, Micah A. Thornton, Anahita Dua","doi":"10.1053/j.semvascsurg.2024.01.001","DOIUrl":"10.1053/j.semvascsurg.2024.01.001","url":null,"abstract":"<div><p>Thoracic outlet syndrome (TOS) consists of a group of disorders resulting from compression of the neurovascular bundle exiting through the thoracic outlet. TOS can be classified as follows based on the etiology of the pathophysiology: neurogenic TOS, venous TOS, arterial TOS, and mixed TOS. The constellation of symptoms a patient may experience varies, depending on the structures involved. Due to the wide range of etiologies and presenting symptoms, treatments for TOS also differ. Furthermore, most studies focus on the perioperative and short-term outcomes after surgical decompression for TOS. This systematic review aimed to provide a pooled analysis of studies to better understand the intermediate and long-term outcomes of surgical decompression for TOS. We conducted a systematic literature search in the Ovid MEDLINE, Embase, and Google Scholar databases for studies that analyzed long-term outcomes after surgical decompression for TOS. The inclusion period was from January 2015 to May 2023. The primary outcome was postoperative QuickDASH Outcome Measure scores. A total of 16 studies were included in the final analysis. The differences between postoperative and preoperative QuickDASH Outcome Measure scores were calculated, when possible, and there was a mean overall difference of 33.5 points (95% CI, 25.2–41.8; <em>P</em> = .001) after surgical decompression. There was a higher proportion of excellent outcomes reported for patients undergoing intervention for arterial and mixed TOS etiologies, whereas those with venous and neurogenic etiologies had the lowest proportion of excellent outcomes reported. Patients with neurogenic TOS had the highest proportion of poor outcomes reported. In conclusion, surgical decompression for TOS has favorable long-term outcomes, especially in patients with arterial and mixed etiologies.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139552176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Thoracic outlet syndrome in women 女性胸廓出口综合征

IF 2.5 3区医学

Seminars in Vascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.semvascsurg.2024.01.002

Grace Carvajal Mulatti , Marcelo Bellini Dalio , Tayrine Mazotti de Moraes , Gabriela Araújo Attie , André Brito-Queiroz , Edwaldo Edner Joviliano

引用次数: 0