![]() In venous or arterial thoracic outlet syndrome, your surgeon may deliver medicines to dissolve blood clots prior to thoracic outlet decompression. You also may need surgery to repair damaged blood vessels. These approaches involve removing a muscle and a part of the first rib to relieve compression. Surgery to treat thoracic outlet syndrome, called thoracic outlet decompression, may be done using several different approaches. Also, surgery may not relieve your symptoms or only partially relieve your symptoms, and symptoms may come back. Thoracic outlet syndrome surgery has risks of complications, such as injury to the nerves, known as the brachial plexus. Or you might consider surgery if you experience ongoing or worsening symptoms.Ī surgeon trained in chest surgery, known as a thoracic surgeon, or blood vessel surgery, known as a vascular surgeon, typically does the procedure. Your healthcare professional may recommend surgery if conservative treatments haven't been effective. Injections of a local anesthetic, onabotulinumtoxinA (Botox) or a steroid medicine may be used to treat neurogenic thoracic outlet syndrome. After you're given thrombolytics, your healthcare professional may prescribe medicines to prevent blood clots, known as anticoagulants. The medicine, known as thrombolytics, goes into your veins or arteries to dissolve blood clots. If you have venous or arterial thoracic outlet syndrome and have blood clots, you may be given a medicine to dissolve the clots. ![]() If there is a blood clot, you may need a blood-thinning medicine. The medicines reduce swelling, reduce pain and encourage muscle relaxation. You may be prescribed anti-inflammatory medicines, pain medicines or muscle relaxants. These exercises, done over time, may take the pressure off the blood vessels and nerves in the thoracic outlet. This improves your range of motion and posture. The exercises strengthen and stretch your shoulder muscles to open the thoracic outlet. If you have neurogenic thoracic outlet syndrome, physical therapy is the first line of treatment. This test can determine if you have nerve damage.Ī conservative approach to treatment may be effective for most people, especially if your condition is diagnosed early. The test checks the electrical activity of your muscles when they contract and when they're at rest. During an EMG, a needle electrode is inserted through your skin into various muscles. If a vein or artery has a clot, doctors can deliver medications through the catheter to dissolve the clot. Healthcare professionals can check to see if you have a compressed vein or artery. Then a dye is injected to show X-ray images of your arteries or veins. The catheter is threaded to the affected blood vessels. During venography, the catheter moves through your veins. During arteriography, the catheter moves through your major arteries. In these tests, a thin, flexible tube called a catheter is inserted through a small cut, often in your groin. This may allow for a better view of the blood vessels in your arm.Īrteriography and venography. A healthcare professional may place your head, shoulders and neck in different positions. These differences in anatomy may be the cause of your symptoms. An MRI may reveal differences in anatomy, such as a fibrous band connecting your spine to your rib or a cervical rib. Sometimes dye is injected to better see the blood vessels. An MRI may be helpful to determine the location and cause of blood vessel compression. An MRI uses radio waves and magnetic fields to create a detailed view of your body. A CT scan may identify the location and cause of blood vessel compression. A dye may be injected into a vein to view the blood vessels in greater detail, known as CT angiography. A CT scan uses X-rays to get cross-sectional images of your body. ![]() X-rays also can help to rule out other conditions that could be causing your symptoms. An X-ray can reveal an extra rib, known as a cervical rib. This test may be used to see if you have venous or arterial thoracic outlet syndrome or other vascular conditions. It's often the first imaging test used to help diagnose thoracic outlet syndrome. An ultrasound uses sound waves to create images of your body. To confirm the diagnosis of thoracic outlet syndrome, you may need one or more of the following tests: You also may be asked about your job duties and physical activities. Tell your healthcare professional about your medical history and symptoms. Knowing which positions and movements trigger your symptoms can help identify thoracic outlet syndrome. Your health professional may reproduce your symptoms by asking you to move or lift your arms or turn your head.
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