{"title":"Management of thoracic outlet syndrome in patients with hemodialysis access","authors":"Arash Fereydooni, Michael David Sgroi","doi":"10.1053/j.semvascsurg.2024.01.004","DOIUrl":"10.1053/j.semvascsurg.2024.01.004","url":null,"abstract":"<div><p>Patients with threatened arteriovenous access are often found to have central venous stenoses at the ipsilateral costoclavicular junction, which may be resistant to endovascular intervention. Stenoses in this location may not resolve unless surgical decompression of thoracic outlet is performed to relieve the extrinsic compression on the subclavian vein. The authors reviewed the management of dialysis patients with central venous lesions at the thoracic outlet, as well as the role of surgical decompression with first-rib resection or claviculectomy for salvage of threatened, ipsilateral dialysis access.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 1","pages":"Pages 50-56"},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139518473","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}
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":"37 1","pages":"Pages 82-89"},"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}
{"title":"The supraclavicular approach to decompression of the thoracic outlet","authors":"Prem Chand Gupta , Prajna B. Kota , Vamsikrishna Yerramsetty , Velladuraichi Boologapandian , Viswanath Atreyapurapu , Pritee Sharma , Ajay Savlania","doi":"10.1053/j.semvascsurg.2024.01.006","DOIUrl":"10.1053/j.semvascsurg.2024.01.006","url":null,"abstract":"<div><p>Surgical decompression of the thoracic outlet, along with treatment of the involved nerve or vessel, is the accepted treatment modality when indicated. Although neurogenic thoracic outlet syndrome (TOS) is often operated via the axillary approach and venous TOS via the paraclavicular approach, arterial TOS is almost always operated via the supraclavicular approach. The supraclavicular approach provides excellent access to the artery, brachial plexus, phrenic nerve, and the cervical and/or first ribs, along with any bony or fibrous or muscular abnormality that may be causing compression of the neurovascular structures. Even for neurogenic TOS, for which the axillary approach offers good cosmesis, the supraclavicular approach helps with adequate decompression while preserving the first rib. This approach may also be sufficient for thin patients with venous TOS. For arterial TOS, a supraclavicular incision usually suffices for excision of bony abnormality and repair of the subclavian artery.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 1","pages":"Pages 57-65"},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139578662","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}
{"title":"Introduction and history of thoracic outlet syndrome","authors":"Anahita Dua , Ramesh K. Tripathi","doi":"10.1053/j.semvascsurg.2024.02.005","DOIUrl":"10.1053/j.semvascsurg.2024.02.005","url":null,"abstract":"","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 1","pages":"Pages 1-2"},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140197406","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}
{"title":"Thoracic outlet syndrome in women","authors":"Grace Carvajal Mulatti , Marcelo Bellini Dalio , Tayrine Mazotti de Moraes , Gabriela Araújo Attie , André Brito-Queiroz , Edwaldo Edner Joviliano","doi":"10.1053/j.semvascsurg.2024.01.002","DOIUrl":"10.1053/j.semvascsurg.2024.01.002","url":null,"abstract":"<div><p>Thoracic outlet syndrome (TOS) is observed more frequently in women, although the exact causes of this sex disparity remain unclear. By investigating the three types of TOS—arterial, neurogenic, and venous—regarding symptoms, diagnosis, and treatment, this article aims to shed light on the current understanding of TOS, focusing on its variations in women.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 1","pages":"Pages 44-49"},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139662013","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}
{"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":"37 1","pages":"Pages 90-97"},"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}
Peter N. Drossopoulos , Colby Ruiz , Jonathan Mengistu , Charlotte B. Smith , Luigi Pascarella
{"title":"Upper-limb neurovascular compression, pectoralis minor and quadrilateral space syndromes: A narrative review of current literature","authors":"Peter N. Drossopoulos , Colby Ruiz , Jonathan Mengistu , Charlotte B. Smith , Luigi Pascarella","doi":"10.1053/j.semvascsurg.2024.02.004","DOIUrl":"10.1053/j.semvascsurg.2024.02.004","url":null,"abstract":"<div><p>Pectoralis minor syndrome (PMS) and quadrilateral space syndrome (QSS) are uncommon neurovascular compression disorders affecting the upper extremity. PMS involves compression under the pectoralis minor muscle, and QSS results from compression in the quadrilateral space—both are classically observed in overhead-motion athletes. Diagnosing PMS and QSS may be challenging due to variable presentations and similarities with other, more common, upper-limb pathologies. Although there is no gold standard diagnostic, local analgesic muscle-block response in a patient with the appropriate clinical context is often all that is required for an accurate diagnosis after excluding more common etiologies. Treatment ranges from conservative physical therapy to decompressive surgery, which is reserved for refractory cases or severe, acute vascular presentations. Decompression generally yields favorable outcomes, with most patients experiencing significant relief and restored baseline function. In conclusion, PMS and QSS, although rare, can cause debilitating upper-extremity symptoms; accurate diagnosis and appropriate treatment offer excellent outcomes, alleviating pain and disability.</p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 1","pages":"Pages 26-34"},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139924806","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}
Yana Etkin (Guest Editors) , Linda M. Harris , Caitlin W. Hicks (Editor-in-Chief)
{"title":"Bridging the Divide: Addressing Sex Disparities in Vascular Surgery","authors":"Yana Etkin (Guest Editors) , Linda M. Harris , Caitlin W. Hicks (Editor-in-Chief)","doi":"10.1053/j.semvascsurg.2023.11.001","DOIUrl":"10.1053/j.semvascsurg.2023.11.001","url":null,"abstract":"","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 4","pages":"Page 475"},"PeriodicalIF":2.5,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135614569","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}
Jeffrey Silpe , Issam Koleilat , Justin Yu , Young Hun Kim , Ella Taubenfeld , Sonia Talathi , Maria Coluccio , Karissa Wang , Karen Woo , Yana Etkin
{"title":"Sex disparities in hemodialysis access outcomes: A systematic review","authors":"Jeffrey Silpe , Issam Koleilat , Justin Yu , Young Hun Kim , Ella Taubenfeld , Sonia Talathi , Maria Coluccio , Karissa Wang , Karen Woo , Yana Etkin","doi":"10.1053/j.semvascsurg.2023.10.002","DOIUrl":"10.1053/j.semvascsurg.2023.10.002","url":null,"abstract":"<div><p><span>The goal of this systematic review<span> was to collate and summarize the current literature on hemodialysis access outcomes in females, identify differences between females and men, and provide a foundation for future research. A systematic review of the English-language literature was conducted by searching PubMed and Google Scholar for the following terms: “sex,” “hemodialysis access,” “arteriovenous </span></span>fistula<span><span>,” “arteriovenous graft,” and “dialysis catheter.” Reference lists from the resulting articles were also evaluated to ensure that any and all relevant primary sources were identified. Studies were then screened by two independent reviewers for inclusion. Of 967 total studies, 53 ultimately met inclusion criteria. Females have lower maturation rates; have decreased rates of primary, primary-assisted, and secondary patency; require more procedures per capita to achieve maturation and to maintain fistula patency; are more likely to receive dialysis via an arteriovenous graft or central venous catheter; and require a longer time and potentially more assistive invasive interventions to achieve a mature fistula. Our findings emphasize the urgent need for further research to evaluate and address the causes of these </span>disparities. Discussion with patients undergoing hemodialysis should include these findings to improve patient education, expectations, satisfaction, and outcomes.</span></p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 4","pages":"Pages 560-570"},"PeriodicalIF":2.5,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136127702","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}
Simon De Freitas , Garietta Falls , Tahlia Weis , Kirran Bakhshi , Lindsey M. Korepta , Carlos F. Bechara , Young Erben , Shipra Arya , Javairiah Fatima
{"title":"Comprehensive framework of factors accounting for worse aortic aneurysm outcomes in females: A scoping review","authors":"Simon De Freitas , Garietta Falls , Tahlia Weis , Kirran Bakhshi , Lindsey M. Korepta , Carlos F. Bechara , Young Erben , Shipra Arya , Javairiah Fatima","doi":"10.1053/j.semvascsurg.2023.10.007","DOIUrl":"10.1053/j.semvascsurg.2023.10.007","url":null,"abstract":"<div><p>Sex-based outcome studies have consistently documented worse results for females undergoing care for abdominal aortic aneurysms<span><span>. This review explores the underlying factors that account for worse outcomes in the females sex. A scoping review of studies reporting sex-based disparities<span> on abdominal aortic aneurysms was performed. The review was conducted in accordance with the Preferred Reporting Items for </span></span>Systematic reviews<span> and Meta-Analyses extension for scoping reviews. Factors that account for worse outcomes in the females sex were identified, grouped into themes, and analyzed. Key findings of each study are reported and a comprehensive framework of these factors is presented. A total of 35 studies were identified as critical in highlighting sex-based disparities in care of patients with aortic aneurysms. We identified the following 10 interrelated themes in the chain of aneurysm care that account for differential outcomes in females: natural history, risk factors, pathobiology, biomechanics, screening, morphology, device design and adherence to instructions for use, technique, trial enrollment, and social determinants. Factors accounting for worse outcomes in the care of females with aortic aneurysms were identified and described. Some factors are immediately actionable, such as screening criteria, whereas device design improvement will require further research and development. This comprehensive framework of factors affecting care of aneurysms in females should serve as a blueprint to develop education, outreach, and future research efforts to improve outcomes in females.</span></span></p></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"36 4","pages":"Pages 508-516"},"PeriodicalIF":2.5,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136127996","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}