Thoracic outlet compression syndrome: current concepts and surgical experience.

Current concepts of the diagnosis of thoracic outlet compression syndrome are presented together with the surgical experience and results obtained in 45 patients. Conservative therapy with exercise, moist heat and physical therapy is advised in patients with mild, non-disabling symptoms, whereas surgical therapy, resection of the first rib, cervical rib, prolonged transverse process or anomalous first rib is recommended in patients with persistent and disabling symptoms. The complications are minor but some serious events with injury to the subclavian artery, vein and brachial plexus have been reported. Good to excellent results can be expected in over 90% of well-selected cases.