Transaxillary decompression of thoracic outlet syndrome.

neurovascular bundle in the thoracic outlet with an estimated incidence of 0.3% to 2% in the general population. The most frequent is the neurogenic TOSTOS , while the arterial and the venous TOSTOS s are relatively uncommon. The diagnosis is essentially clinic, supported by imaging. The aim of this study was to present our experience in surgical decompression of TOSTOS through transaxillary approach. METHODS : A retrospective study was conducted on a prospectively compiled, computerized database between May 2014 and June 2018 including patients affected by TOS surgically treated in our center. We obtained diagnosis firstly considering clinical presentation and physical examination; then performing chest radiography, computed tomography angiography and/or magnetic resonance imaging, which can exclude other cause for patient’s symptoms. R ESULTS SULTS : Of the 16 patients, 14 were women (87.5%) and 2 were man (12.5%). Median age was 37.4±10.6. Clinical presentation was neurological in 10 patients (62.5%), venous in 3 (18.7%) and arterial in 1 patient (6.25%). In two patients (12.5%) both neurological and venous symptoms were present. Two patients (12.5%) had bilateral TOSTOS . Technical success was achieved in all cases. The main perioperative complication was pneumothorax in 8 patients (50%). Neurological complications or nerve injury were null. Symptoms recurrence was 6.25%. CONCLUS IONS : In our experience transaxillary approach is a safe and feasible procedure associated with an acceptable rate of peri-operative morbidity and satisfactory long-term relief of symptoms. (Cite this article as: Stilo F, Montelione N, Vigliotti RC , Spinelli F. Transaxillary decompression of thoracic outlet syndrome. Ital J Vasc Endovasc Surg 2019;26:6-9. DO I: 10.23736/S1824-4777.18.01394-3)