A severe case of vascular thoracic outlet syndrome

We report a 21-year-old patient who presented at the outpatient department of angiology with incipient necroses in the fingertips of the right hand. C olour-coded duplex sonography and angiography demonstrated occlusion of the right brachial, ulnar and radial arteries, obviously resulting from an emb olism from the subclavian artery narrowed by a cervical rib, After partly s uccessful local thrombolysis this accessory rib was resected. We review ang iologic signs and neurological symptoms of the thoracic outlet syndrome (TO S) and analyse the current literature regarding diagnostic procedures and t reatment. This complicated and severe case of TOS in a young patient ending with paresis of the right arm and partial finger amputation emphasises the importance of early diagnosis of this condition.