Abstract：
Arterial thoracic outlet syndrome (TOS) is a condition in which anatomic abnormalities in the thoracic outlet cause compression of the subclavian or, less commonly, axillary artery. Patients are usually younger and typically have an anatomic abnormality causing the compression. The condition usually goes undiagnosed until patients present with signs of acute or chronic hand or arm ischemia. Workup of this condition includes a thorough history and physical examination; chest x-ray to identify potential anatomic abnormalities; and arterial imaging, such as computed tomographic angiography or duplex to identify arterial abnormalities. Patients will usually require operative intervention, given their symptomatic presentation. Intervention should always include decompression of the thoracic outlet with at least a first-rib resection and any other structures causing external compression. If the artery is identified to have intimal damage, mural thrombus, or is aneurysmal, then arterial reconstruction is warranted. Stenting should be avoided due to external compression. In patients with symptoms of embolization, a combination of embolectomy, lytic catheter placement, and/or therapeutic anticoagulation should be done. Typically, patients have excellent outcomes, with resolution of symptoms and high patency of the bypass graft, although patients with distal embolization may require finger amputation.
摘要：
动脉性胸廓出口综合征（TOS）是一种在胸廓出口的解剖异常引起锁骨下压迫或，不太常见，腋窝动脉.患者通常较年轻，通常具有引起压迫的解剖异常。这种情况通常无法诊断，直到患者出现急性或慢性手或手臂缺血的迹象。这种情况的检查包括全面的病史和体格检查;胸部X光检查以确定潜在的解剖异常;和动脉成像，如计算机断层扫描血管造影或双工来识别动脉异常。患者通常需要手术干预，鉴于他们的症状表现。干预应始终包括至少进行第一肋骨切除和任何其他引起外部压迫的结构对胸出口进行减压。如果确定动脉有内膜损伤，壁血栓,或者是动脉瘤，然后动脉重建是必要的。应避免由于外部压缩而造成的支架。在有栓塞症状的患者中，栓子切除术的组合，溶解导管放置,和/或治疗性抗凝。通常,患者有很好的结果，随着症状的缓解和旁路移植物的高度通畅，虽然远端栓塞患者可能需要手指截肢。
