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Differential Diagnosis, Decision-Making, and Pathways of Care for ATOS

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Abstract

The diagnosis of arterial thoracic outlet syndrome (ATOS) is made when the patient’s primary symptoms are arterial in nature even though the patient may also have neurogenic or venous symptoms. The neurovascular bundle in the thoracic outlet is compressed when the arm and shoulder are placed in certain positions in many patients without symptoms. In some, however, repeated injury may occur and produce arterial wall injury leading to endothelial ulceration, clot formation, post-stenotic aneurysmal dilatation, digital embolization, forearm vessel occlusion, and/or proximal arterial occlusion. This process is often silent and progressive. Subclavian-axillary artery lesions may be produced by either abnormal bony structures or normal structures that become abnormal with certain arm positioning.

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Authors and Affiliations

  1. Department of Surgery, Division of Vascular Surgery, Feinberg School of Medicine, Northwestern University, 676 North St. Clair Suite 650, Chicago, IL, 60611, USA

    William H. Pearce MD

Authors
  1. William H. Pearce MD
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Correspondence to William H. Pearce MD .

Editor information

Editors and Affiliations

  1. , Division of Vascular Surgery, University of South Florida, Tampa General Circle, STC 7016 2, Tampa, 33606, Florida, USA

    Karl A. Illig

  2. Barnes-Jewish Hospital, Department of Surgery, Washington University, Queeny Tower Campus Box, St. Louis, 63110, Missouri, USA

    Robert W. Thompson

  3. , Department of Surgery, John Hopkins Medical Institutions, Rutland Avenue - Ross 759 729, Baltimore, 21205, Maryland, USA

    Julie Ann Freischlag

  4. , Department of Thoracic Surgery, Blake 15, Massachusetts General Hospital, Fruit Street 55, Boston, 02114, Massachusetts, USA

    Dean M. Donahue

  5. Neurological Associates of West LA, Wilshire Blvd, Suite 790 2811, Santa Monica, 90403, California, USA

    Sheldon E. Jordan

  6. , Graduate Program in Physical Therapy, UCSF/SFSU, Balmoral Street 2429, Union City, 94587, California, USA

    Peter I. Edgelow

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© 2013 Springer-Verlag London

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Pearce, W.H. (2013). Differential Diagnosis, Decision-Making, and Pathways of Care for ATOS. In: Illig, K., Thompson, R., Freischlag, J., Donahue, D., Jordan, S., Edgelow, P. (eds) Thoracic Outlet Syndrome. Springer, London. https://doi.org/10.1007/978-1-4471-4366-6_83

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  • DOI: https://doi.org/10.1007/978-1-4471-4366-6_83

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4365-9

  • Online ISBN: 978-1-4471-4366-6

  • eBook Packages: MedicineMedicine (R0)

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