TY - JOUR
T1 - Preoperative Duplex Scanning is a Helpful Diagnostic Tool in Neurogenic Thoracic Outlet Syndrome
AU - Orlando, Megan S.
AU - Likes, Kendall C.
AU - Mirza, Serene
AU - Cao, Yue
AU - Cohen, Anne
AU - Lum, Ying Wei
AU - Freischlag, Julie A.
N1 - Publisher Copyright:
© SAGE Publications.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Objective: To evaluate the diagnostic role of venous and arterial duplex scanning in neurogenic thoracic outlet syndrome (NTOS). Methods: Retrospective review of patients who underwent duplex ultrasonography prior to first rib resection and scalenectomy (FRRS) for NTOS from 2005 to 2013. Abnormal scans included ipsilateral compression (IC) with abduction of the symptomatic extremity (>50% change in subclavian vessel flow), contralateral (asymptomatic side) compression (CC) or bilateral compression (BC). Results: A total of 143 patients (76% female, average age 34, range 13-59) underwent bilateral preoperative duplex scanning. Ipsilateral compression was seen in 44 (31%), CC in 12 (8%), and BC in 14 (10%). Seventy-three (51%) patients demonstrated no compression. Patients with IC more often experienced intraoperative pneumothoraces (49% vs. 25%, P <.05) and had positive Adson tests (86% vs. 61%, P <.02). Conclusion: Compression of the subclavian vein or artery on duplex ultrasonography can assist in NTOS diagnosis. Ipsilateral compression on abduction often correlates with Adson testing.
AB - Objective: To evaluate the diagnostic role of venous and arterial duplex scanning in neurogenic thoracic outlet syndrome (NTOS). Methods: Retrospective review of patients who underwent duplex ultrasonography prior to first rib resection and scalenectomy (FRRS) for NTOS from 2005 to 2013. Abnormal scans included ipsilateral compression (IC) with abduction of the symptomatic extremity (>50% change in subclavian vessel flow), contralateral (asymptomatic side) compression (CC) or bilateral compression (BC). Results: A total of 143 patients (76% female, average age 34, range 13-59) underwent bilateral preoperative duplex scanning. Ipsilateral compression was seen in 44 (31%), CC in 12 (8%), and BC in 14 (10%). Seventy-three (51%) patients demonstrated no compression. Patients with IC more often experienced intraoperative pneumothoraces (49% vs. 25%, P <.05) and had positive Adson tests (86% vs. 61%, P <.02). Conclusion: Compression of the subclavian vein or artery on duplex ultrasonography can assist in NTOS diagnosis. Ipsilateral compression on abduction often correlates with Adson testing.
KW - duplex ultrasonography
KW - first rib resection and scalenectomy
KW - neurogenic thoracic outlet syndrome
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U2 - 10.1177/1538574415623650
DO - 10.1177/1538574415623650
M3 - Article
C2 - 26744377
AN - SCOPUS:84958213302
SN - 1538-5744
VL - 50
SP - 29
EP - 32
JO - Vascular and endovascular surgery
JF - Vascular and endovascular surgery
IS - 1
ER -