Chapter 122 - Arterial TOS

Question 1

Naffziger syndrome

Answer 1

Compression of the subclavian artery and brachial prexus

Question 2

Term of TOS first u sed

Answer 2

1956 Peet

Question 3

Causes of aTOS

Answer 3

Cervical rib 60% Anomalous first rib 18% Fibrocartilaginous band 15% Clavicular fracture 6% enlarged C7 transverse process 1%

Question 4

Epidemiology of aTOS

Answer 4

young active adults age 32-37 average

Question 5

Presentation of aTOS

Answer 5

1) hand ischemia 2) Exertional arm pain 3) Raynaud syndrome 4) palpable aneurysm 5) CVA

Question 6

Physical findings of aTOS

Answer 6

1) palpable cervical rib 2) pulsatile supraclavicular mass 3) signs of emboli

Question 7

Duplex finding of complete occlusion can exist in normal subjects %

Answer 7

20%

Question 8

Best imaging test for aTOS

Answer 8

CTA DSA to determine extent of occlusion and emboli

Question 9

Rate of bilateral cervical ribs

Answer 9

40%

Question 10

rate of bilateral TOS of all types

Answer 10

9-26%

Question 11

Conservative management of aTOS

Answer 11

asymptomatic then no treatment watchful waiting

Question 12

Aneurysm associated with aTOS definition

Answer 12

Increase in diameter > 2x the adjacent artery

Question 13

Scher staging classification and treatment of aTOS

Answer 13

TABLE 122.2

Question 14

Symptom relief after aTOS surgery and bypass

Answer 14

90%

Question 15

Bypass patency after aTOS

Answer 15

90-100% generally long lasting

Question 16

Morbidity after aTOS repair

Answer 16

7-40% transient brachial plexus injury pleural entry