Neurogenic thoracic outlet syndrome (NTOS) presents with symptoms and signs arising from compression and irritation of the brachial plexus at the scalene triangle or pectoralis minor space. Identifying this specific anatomical mechanism is central to determining the appropriate management pathway.
This protocol applies to patients with neurogenic thoracic outlet syndrome in whom symptoms are caused by brachial plexus compression or irritation at the scalene triangle or pectoralis minor space. Diagnosis of NTOS requires the presence of qualifying clinical criteria based on the specific constellation of symptoms and signs described in the guideline.
The structured evidence-based regimen for this scenario involves a surgical approach targeting decompression of the thoracic outlet — the full algorithm, operative details, and additional procedural components are available in the complete protocol.
DOI: 10.1016/j.jvs.2016.04.039
Patients have symptoms caused by compression and irritation of the brachial plexus causing symptoms and signs as described in the later section.
NTOS should be defined by the presence of three of the following four criteria.
Operative decompression of the thoracic outlet, potentially including brachial plexus neurolysis.
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