• Abdulmajeed Altoijry, Hesham AlGhofili, Kaisor Iqbal, Talal A Altuwaijri, Sultan Alsheikh, Musaad AlHamzah, Elham Khoujah, Mahmoud T AbuAlnasr, Badr Aljabri, and Mussaad Al-Salman.
• From the Division of Vascular Surgery (Altoijry, AlGhofili, Iqbal, Altuwaijri, Alsheikh, AlHamzah, Khoujah, Aljabri, Al-Salman), Department of Surgery, College of Medicine, King Saud University, and from College of Medicine (AbuAlnasr), Al-Faisal University, Riyadh, Kingdom of Saudi Arabia.
• Saudi Med J. 2022 Jul 1; 43 (7): 743750743-750.

ObjectivesTo outline our experience with both arterial vascular thoracic outlet syndrome (ATOS) and venous TOS (VTOS).MethodsThis was a retrospective review carried out at King Saud University Medical City, Riyadh, Saudi Arabia, from 1992-2022. All patients were diagnosed based on clinical presentation, imaging, and underwent surgical decompression solely via the supraclavicular approach. The median follow-up period was 18 months (range: 4-36 months).ResultsA total of 90 limbs were diagnosed with vascular TOS in 69 patients. Females accounted for 69.6% of the patients and approximately 86.7% had ATOS. All patients were symptomatic and underwent plain thoracic inlet and cervical spine radiography, along with duplex scans in both rest and provocative positions. Total cervical rib resection was carried out in 60% of cases, while 2% had partial resection. First rib resection was carried out in 13.3% of cases and combined cervical and first rib resections were carried out in 23.3%. Vascular procedures were needed for arterial repair in 20% of cases, while venous repair were carried out in 2.2%. No recurrence or post-operative mortality had been reported. Post-operative complications were observed in 18.9% of cases.ConclusionCareful patient selection and diagnosis using advanced, but less invasive radiological imaging coupled with adequate surgical treatment can improve the patient's outcome.Copyright: © Saudi Medical Journal.

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