Henry Ford’s experienced vascular surgeons and neurosurgeons offer the latest treatments for all forms of thoracic outlet syndrome. As your care partner, we work closely with you to customize a treatment plan to relieve your symptoms and prevent serious complications. Your treatment options depend on the form of thoracic outlet syndrome you have.
Initial treatment for all forms of thoracic outlet syndrome
In the early stages of thoracic outlet syndrome, you may experience mild symptoms. We can manage your care with conservative therapies. For all forms, we typically begin with one or more of these options:
- Pain medications: Over-the-counter, nonsteroidal anti-inflammatory drugs (NSAIDs) may be all you need for pain. We can also prescribe muscle relaxants as needed.
- Physical therapy: You’ll work with our licensed physical therapists on exercises to increase your range of motion and improve your posture. These exercises can strengthen and stretch neck and shoulder muscles enough to open the thoracic outlet, avoiding the need for surgery.
Surgery for neurogenic thoracic outlet syndrome
If conservative treatment isn’t effective or your symptoms get worse, thoracic outlet decompression surgery can provide an option. If you have the neurogenic form, you might see our vascular surgeons or our neurosurgeons.
Our surgeons operate to relieve pressure on motor and sensory nerves to the hand and arm. We use an open procedure to removing the source of pressure, which could be:
- Extra rib
- All or part of the first rib
- Abnormal muscles or connective tissue
Additional treatment for venous thoracic outlet syndrome
Our vascular surgeons oversee your care if you have the venous form. Depending on your specific symptoms, you may need a minimally invasive procedure from our interventional radiologists. If you need surgery to remove the source of the compression, our vascular surgeons have expertise in thoracic outlet decompression surgery.
Your treatment options include:
- Anticoagulant medications: Blood thinners help prevent blood clots from forming.
- Catheter-directed thrombolysis: If you have a blood clot in the compressed vein, our interventional radiology team performs a minimally invasive procedure to dissolve the clot. Your doctor inserts a catheter (thin, flexible tube) through a tiny incision in a vein and guides it to the clot. Using the catheter, the doctor delivers clot-dissolving medication directly to the clot.
- Thoracic outlet decompression surgery: Your vascular surgeon performs open surgery to remove all or part of the first rib and certain muscles in the neck and collarbone area.
Additional treatment for arterial thoracic outlet syndrome
If you have arterial thoracic outlet syndrome, our vascular surgeons oversee your care.
Some people need a minimally invasive procedure from our interventional radiologists. But most people require surgery to relieve pressure on the affected arteries. Surgery to treat arterial thoracic outlet syndrome is highly effective, relieving symptoms about 95 percent of the time . Relieving pressure restores blood flow to your arm and avoids the risk of gangrene (tissue death) and limb loss.
Treatment options for arterial thoracic outlet syndrome include:
- Anticoagulant medications: Blood thinners help prevent blood clots.
- Catheter-directed thrombolysis: If you have a blood clot in the compressed artery, our interventional radiology team performs a minimally invasive procedure to dissolve the clot.
- Thoracic outlet decompression surgery: Your vascular surgeon performs an open procedure to remove:
- The extra rib, if present
- All or part of the first rib
- Certain muscles in the neck
- Artery reconstruction: If the compressed artery is damaged or has a bulge (aneurysm), your surgeon can replace the damaged section. We typically reconstruct arteries during the same procedure as decompression surgery. We replace the damaged section with an artificial graft or a section of artery from elsewhere in your body.