Directions in Clinical Research on ATOS

  • Ali Azizzadeh
  • Louis L. Nguyen
  • Robert W. Thompson


Arterial thoracic outlet syndrome (TOS) is the least frequent but likely most complex form of TOS. It most frequently occurs in relatively young, active, and otherwise healthy individuals. It is primarily caused by bony abnormalities, such as cervical ribs and anomalous first ribs. In this condition, longstanding subclavian artery compression leads to poststenotic dilatation and ulceration or aneurysmal degeneration, followed by occlusive thrombosis or mural thrombus formation with distal embolization to the arm and/or hand. Many clinical questions regarding diagnosis and optimal management of arterial TOS remain unanswered. The development of an international registry for patients with arterial TOS, along with standards for characterizing patients and reporting clinical outcomes, would provide useful data to help guide the optimal management of this rare and challenging clinical condition.


Ischemia Aspirin Clopidogrel PTFE 


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Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  • Ali Azizzadeh
    • 1
  • Louis L. Nguyen
    • 2
  • Robert W. Thompson
    • 3
  1. 1.Department of Cardiothoracic and Vascular SurgeryUniversity of Texas Medical School, Memorial Hermann Heart and Vascular InstituteHoustonUSA
  2. 2.Department of Vascular and Endovascular SurgeryBrigham and Women’s HospitalBostonUSA
  3. 3.Department of Surgery, Section of Vascular Surgery, Center for Thoracic Outlet SyndromeWashington University, Barnes-Jewish HospitalSt. LouisUSA

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