article · Georgian Medical Journal
Thoracic outlet syndrome is an uncommon neurovascular condition that typically presents in young women exposed to repetitive occupational physical movements. This clinical account describes a 61-year-old male patient who presented with an exceptionally rare mixed form of neurovascular thoracic outlet syndrome involving simultaneous compression of nervous, venous, and arterial pathways. Initial conservative management failed to alleviate the patient's symptoms. In response, clinicians conducted a two-stage surgical decompression procedure using a supraclavicular approach together with a deltopectoral incision. At a one-year follow-up examination, the surgical approach resulted in the complete resolution of the patient's symptoms, highlighting a successful operative strategy for addressing combined neurovascular compression.
Thoracic outlet syndrome can present atypically and mimic other conditions, potentially complicating accurate diagnosis. Demonstrating that complex cases involving simultaneous nerve, vein, and artery compression can be successfully resolved through a phased surgical approach provides valuable guidance for clinicians managing patients who do not respond to non-surgical therapies.
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Abstract: Thoracic outlet syndrome is a rare neurovascular pathology generally affecting young women exposed to repetitive occupational movements. We report the case of a 61-year-old man who presented with a neurovascular thoracic outlet syndrome involving concurrent nervous, venous, and arterial compression — an exceptionally rare mixed form. Following failure of conservative management, two-stage surgical decompression was performed via a supraclavicular approach and a deltopectoral incision, resulting in complete resolution of symptoms at one-year follow-up. Keywords: thoracic outlet syndrome; neurovascular; cervicothoracic defilement; scalenectomy; brachial plexus; cervical rib; case report
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DOI: 10.66636/gmj.v1.i3.a128
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