Abstract:
BACKGROUND:The purpose of this study was to categorize patients referred to a specialized thoracic outlet syndrome (TOS) practice to determine the diagnostic accuracy of those who are physician and self-referred. METHODS:Demographic and clinical data on all patients who were referred for TOS between 2006 and 2010 were retrospectively reviewed from a prospectively maintained institutional review board-approved database and patient records. RESULTS:Between 2006 and 2010, 621 patients were referred for TOS (433 women and 188 men; mean age 39 years [range 10-87]). Five hundred seventy-one patients (92%) were diagnosed with TOS, with 421 (74%) neurogenic, 126 (22%) venous, and 24 (4%) arterial TOS cases. Of the 525 physician referrals, 478 (91%) had TOS, and of the 93 self-referrals, 90 (97%) had TOS. The 421 patients with neurogenic TOS (NTOS, 304 women and 117 men) had symptoms on average for 56 months (range 1-516). Two hundred seventy-one patients (64%) were initially treated with TOS-specific physical therapy (PT), and 100 (37%) improved. One hundred seventy-eight patients (42%) underwent a lidocaine block, and 145 patients (81%) had a positive block. Seventy-four patients (18%) underwent Botox injections 44 (60%) of which were positive and the average number of Botox injections was 1.3. One hundred forty patients (33%) underwent transaxillary first rib resection and scalenectomy (FRRS), and 128 patients (91%) improved. Of patients undergoing FRRS, 92 (66%) had a lidocaine block, 82 (89%) of which were positive. Of patients with a positive lidocaine block, 74 (90%) improved after FRRS. Of patients undergoing FRRS, 31 (22%) underwent Botox injections, 15 (48%) of which were positive. Of patients with a positive Botox block, 14 (93%) improved after FRRS. Average length of time between initial visit and operation was 6.4 months (range 2 weeks to 34 months), and average follow-up time was 13 months (range 1 week to 49 months). CONCLUSIONS:1) Both referring physicians and patients are very accurate in their preliminary diagnosis of TOS (neurogenic, venous, or arterial TOS). 2) In a specialized TOS practice, two-thirds of patients are sent to TOS-specific PT and one-third improve from this treatment alone. 3) One-third of patients referred for NTOS eventually undergo FRRS with a 91% success rate.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Likes K,Rochlin DH,Salditch Q,Dapash T,Baker Y,DeGuzman R,Selvarajah S,Freischlag JAdoi
10.1016/j.avsg.2013.12.011subject
Has Abstractpub_date
2014-07-01 00:00:00pages
1100-5issue
5eissn
0890-5096issn
1615-5947pii
S0890-5096(14)00046-6journal_volume
28pub_type
杂志文章abstract::Parkes Weber syndrome (PWS) is characterized by the association of high flow vascular malformation and overgrowth of a part of the body, usually a limb. In a previous review of 10 patients with PWS from our hospital we described a case of congenital short femur and four cases of severe lymphedema. We present a case of...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.06.015
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Mentoring relationships have been encouraged for medical students interested in surgical specialties. We investigated the role of mentoring relationships of integrated vascular surgery residents, while in medical school. We hypothesized that mentoring relationships between medical students and vascular surge...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.03.033
更新日期:2020-04-01 00:00:00
abstract::This prospective study was undertaken to evaluate the role of duplex Doppler (DD) scanning in the diagnosis of masses of suspected vascular origin at the carotid bifurcation. We also assessed the different DD signs of carotid body tumors, especially the difference in resistance index (RI) in the external carotid arter...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02001007
更新日期:1993-03-01 00:00:00
abstract::A retrospective analysis of 56 patients undergoing ruptured abdominal aortic aneurysm (AAA) repair was performed to find out if cell saver had any impact on postoperative morbidity and mortality. All patients but one were male. The mean age was 68 +/- 8 years (35-85 years). Cell saver was used in 40 patients (CS group...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0123-7
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Type II endoleaks are the most common complications after endovascular repair of abdominal aortic aneurysms (EVARs). Some studies have shown the benefit of preventive inferior mesenteric artery (IMA) embolization, but its efficacy and cost-effectiveness continue to be controversial. The aim of this study was...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.03.012
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The pathophysiological mechanisms that induce postrevascularization edema after femoropopliteal bypass surgery are not completely understood. Reperfusion-associated injury to revascularized tissue and damage to lymphatic structures are both likely to play a role. Aim of this study was to study edema formatio...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.04.010
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Delirium in patients with critical limb ischemia (CLI) is associated with increased mortality. The main goal of this study was to investigate the association between delirium and mortality in patients undergoing major lower limb amputation for CLI. In addition, other risk factors associated with mortality we...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.02.014
更新日期:2019-10-01 00:00:00
abstract::The axillary artery approach has been used for access for complex endovascular aortic procedures such as thoracic endovascular aortic repair with poor anatomy for traditional deployment as well as for fenestrated and branched abdominal aortic endografts. We report the first case of an iliac graft limb deployment throu...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.09.014
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:The endovascular approach has been widely used for aortoiliac occlusive disease (AIOD), especially for aortic bifurcation and iliac artery Trans-Atlantic Inter-Society Consensus II (TASC-II) A and B lesions. However, the outcomes of self-expanding covered stents (SECSs) for extensive aortoiliac lesion remain...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.04.055
更新日期:2020-10-01 00:00:00
abstract::A patient presenting with urinary retention was found to have progressive spinal cord ischemia subsequent to an end-to-side aortobifemoral bypass for atherosclerotic disease. This serves as a vivid reminder of the possibility of this complication even in ischemic disease and that urinary retention may be the initial s...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02000153
更新日期:1993-11-01 00:00:00
abstract::Vascular anomaly is a general term that includes all vascular malformations, vascular tumors, and other congenital vascular defects. Vascular malformation is the most common term, and it describes blood vessels that are abnormally formed at birth. Vascular malformations can develop in any part of the body. The most co...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.02.040
更新日期:2019-08-01 00:00:00
abstract::The pathophysiological implications of Chlamydia pneumoniae in atherosclerotic lesions and its contribution to atherosclerotic complications remain unclear. Therefore, the purpose of the present study was to evaluate whether or not there is an association between the presence of Chlamydia pneumoniae in atherosclerotic...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0178-5
更新日期:2002-07-01 00:00:00
abstract::Exposure of the distal internal carotid artery (ICA) above the level of the second cervical vertebra can be difficult and often require maneuvers such as division of the digastric muscle or mandibular subluxation. These techniques increase exposure but may not provide adequate access. We report a series of eight cases...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100160010010
更新日期:2001-01-01 00:00:00
abstract::In this retrospective study, we reviewed the records of 62 patients who were treated at a tertiary care community teaching hospital between 1977 and 1987 for major arterial injury caused by blunt trauma. Nearly half (45%, 28/62) of the injuries were to the thoracic aorta, 24% (15/62) were to arteries of the head and n...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60158-1
更新日期:1989-10-01 00:00:00
abstract::Severe hyperhidrosis is a disabling disorder whose management is controversial. Medical treatment consists of topical aluminum chloride, oral anticholinergics, ionotophoresis, and botulinum toxin A (Botox) injections. Despite the minimally invasive nature of thoracoscopic sympathectomy, there is a common perception th...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2008.04.014
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:We reviewed our experience to determine the effect of epidural versus intravenous analgesia on postoperative pulmonary function and pain control in patients with chronic obstructive pulmonary disease (COPD) undergoing open surgery for abdominal aortic aneurysm. METHODS:A retrospective study with prospective...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.04.009
更新日期:2012-02-01 00:00:00
abstract::Pseudoaneurysm (PA) formation after carotid endarterectomy (CEA) is a very uncommon but dangerous complication, potentially responsible for cerebral embolism or rupture. Therefore, the PA treatment is imperative. Until few years ago, the treatment of choice was represented by open surgical repair, with a higher mortal...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.02.051
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Revascularization of aortic arch vessels was performed with thoracic endovascular aortic repair (TEVAR) to preserve the endoprosthesis landing zone in 19 high-risk patients. METHODS:The operative procedure used was a bypass or transposition involving the common carotid and subclavian arteries. Homemade fene...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.12.018
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Abdominal aortic aneurysm (AAA) is a common and lethal disease. AAAs are associated with atherosclerosis, chronic inflammation, and extracellular matrix degradation. The aim of this study was to determine whether treatment with simvastatin can influence the development of experimental aortic aneurysms in a r...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.09.003
更新日期:2012-02-01 00:00:00
abstract::Cryosurgery is a relatively new treatment option for vein stripping in case of insufficiency of the great saphenous vein (GSV). A prospective randomized trial was performed to compare operation time, extracted vein length, and postoperative outcomes of cryosurgery with conventional short stripping. Forty patients with...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s10016-006-9051-x
更新日期:2006-05-01 00:00:00
abstract::Transcatheter embolization of hypogastric artery aneurysms has become an attractive therapeutic alternative for many patients with this difficult lesion. Because of the increasing use of stent grafting for treatment of abdominal aortic aneurysms, transcatheter embolization of normal-caliber hypogastric arteries has be...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-004-0032-7
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Postopertive troponin elevation may occur without typical or atypical cardiac symptoms and is associated with an increased 30-day morbidity and mortality. The objective of the study was to implement a quality improvement initiative of postoperative troponin surveillance algorithm aimed at intensifying medica...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.02.025
更新日期:2019-10-01 00:00:00
abstract::Percutaneous endovenous techniques, such as radiofrequency ablation (RFA), have become the preferred method for treatment for varicose veins associated with great saphenous vein (GSV) insufficiency. Reports have shown safety and efficacy of these techniques with relatively few complications. Deep venous thrombosis aft...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.07.005
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:The aim of this study was to ascertain the technical difficulties and complications of video-assisted thoracic sympathectomy (VTAS) in the treatment of hyperhidrosis in a large group of patients. METHODS:Between October 1995 and February 2008, 1731 patients with palmar, axillary, or craniofacial hyperhidros...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.05.026
更新日期:2013-05-01 00:00:00
abstract::A 75-year-old immunosuppressed man presented with fever and central abdominal pain 3 weeks after having positive blood cultures for Salmonella enteritidis. A computed tomography scan demonstrated a contained perforation of a nonaneurysmal abdominal aorta. Salmonella aortitis was suspected, and given his recent history...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.11.019
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:The aim of this study was to report the feasibility and outcomes with the endovascular treatment of spontaneous internal carotid artery dissections (ICADs) using a proximal embolic protection device (EPD). METHODS:This is a retrospective analysis of patients treated for spontaneous symptomatic ICAD using a ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.12.019
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:In recent years, endovascular treatment of subclavian artery pseudoaneurysm (SAP) has been recommended by many experts. The aim of this study is to evaluate the safety and efficacy of the endovascular treatment of SAP, and to introduce our experience in the diagnosis and treatment of SAP. METHODS:A total of...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.10.096
更新日期:2020-05-01 00:00:00
abstract::Vascular prosthetic infection is a rare but serious complication of vascular surgery that requires rapid diagnosis and treatment. It is associated with high rates of amputation and death. The diagnosis is difficult when faced with a chronic nonspecific clinical presentation. We report 2 cases showing the diagnostic us...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.07.030
更新日期:2014-04-01 00:00:00
abstract::We report the use of manufacturer-customized fenestrated iliac stent grafts to treat common iliac artery aneurysms (CIAAs) in patients with challenging iliac anatomy, unsuitable for iliac branched devices (IBDs). A 71-year-old woman presented with bilateral CIAAs measuring 44 mm and 29 mm and a perivisceral abdominal ...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.02.044
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the performance of paclitaxel-eluting stents (PESs) and paclitaxel-coated balloons (PCBs) on amputation-free survival in patients with critical limb ischemia (CLI). METHODS:A retrospective review of all patients with Rutherford stage 5 and 6 limb ischemia undergoing endo...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.05.013
更新日期:2020-01-01 00:00:00