{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:42:11Z","timestamp":1792608131877,"version":"4.5.0"},"reference-count":0,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2003,5,1]],"date-time":"2003-05-01T00:00:00Z","timestamp":1051747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2003,5]]},"abstract":"Abstract<\/jats:p>The surgical treatment of 30 cases of vascular thoracic outlet syndrome (TOS) in 25 patients is presented. Patients included 17 women and 8\u00a0men with average age of 26.1 years. The causes of compression were cervical rib (n<\/jats:italic> = 16), soft tissue anomalies (n<\/jats:italic> = 12), and scar tissue after clavicle fracture (n<\/jats:italic> = 2). Ten subclavian artery aneurysms containing intraluminal thrombus as well as one subclavian artery occlusion were found. All such cases had multiple distal arterial embolization. Presenting features of cases with arterial TOS included: hand ischemia (n<\/jats:italic> = 11), transient ischemic attack (TIA) (n<\/jats:italic> = 1), and claudication or vasomotor phenomena during the arm hyperabduction (n<\/jats:italic> = 11). Two patients with venous TOS developed hand edema during arm hyperabduction, and five other patients had axillary\u2010subclavian venous thrombosis. In all cases decompressive procedures using a combined supraclavicular and infraclavicular approach were performed. Decompression was achieved by cervical rib excision (n<\/jats:italic> = 12), combined cervical and first rib excision (n<\/jats:italic> = 4), and first rib excision (n<\/jats:italic> = 14). In all cases division of all soft tissue elements was also accomplished. Associated vascular procedures included resection and replacement of 10 subclavian artery aneurysms, one subclavian\u2010axillary and one axillary\u2010brachial bypass, as well as nine brachial embolectomies. All five cases with axillary\u2010subclavian vein thrombosis before decompression were treated with anticoagulant therapy. The mean follow\u2010up period was 3 years and 2\u00a0months (range 1 to 6 years). Two pleural entry injuries and two transient brachial plexus injuries were noted. All reconstructed arteries were patent during the follow\u2010up period. Complete resolution of symptoms with a return to full activity was noticed in all cases with arterial TOS and in two cases with venous TOS without axillary\u2010subclavian vein thrombosis. In cases with axillary\u2010subclavian vein thrombosis relief of symptoms was mild, and there were limitations on daily activity. Vascular TOS is seen less frequently than the neurogenic form; however, in most cases it requires surgical treatment. We prefer a combined supraclavicular and infraclavicular approach because it offers complete exposure of the subclavian artery, cervical and first ribs, and all soft tissue anomalies.<\/jats:p>","DOI":"10.1007\/s00268-003-6808-z","type":"journal-article","created":{"date-parts":[[2003,5,13]],"date-time":"2003-05-13T15:25:44Z","timestamp":1052839544000},"page":"545-550","source":"Crossref","is-referenced-by-count":71,"title":["Vascular Thoracic Outlet Syndrome"],"prefix":"10.1002","volume":"27","author":[{"given":"Lazar B.","family":"Davidovic","sequence":"first","affiliation":[{"name":"Institute for Cardiovascular Diseases Serbian Clinical Centre 8, K. Todorovica St. 11 000 Belgrade Yugoslavia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dusan M.","family":"Kostic","sequence":"additional","affiliation":[{"name":"Institute for Cardiovascular Diseases Serbian Clinical Centre 8, K. Todorovica St. 11 000 Belgrade Yugoslavia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nenad S.","family":"Jakovljevic","sequence":"additional","affiliation":[{"name":"Institute for Cardiovascular Diseases Serbian Clinical Centre 8, K. Todorovica St. 11 000 Belgrade Yugoslavia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilija L.","family":"Kuzmanovic","sequence":"additional","affiliation":[{"name":"Institute for Cardiovascular Diseases Serbian Clinical Centre 8, K. Todorovica St. 11 000 Belgrade Yugoslavia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tijana M.","family":"Simic","sequence":"additional","affiliation":[{"name":"Institute for Cardiovascular Diseases Serbian Clinical Centre 8, K. Todorovica St. 11 000 Belgrade Yugoslavia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2003,5]]},"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-003-6808-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-003-6808-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-003-6808-z","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T16:23:29Z","timestamp":1704990209000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-003-6808-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,5]]},"references-count":0,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2003,5]]}},"alternative-id":["10.1007\/s00268-003-6808-z"],"URL":"https:\/\/doi.org\/10.1007\/s00268-003-6808-z","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,5]]}}}