Abstract：
Objective.In patients with suspected thoracic outlet syndrome (TOS), diagnosing inter-scalene compression could lead to minimally invasive treatments. During photo-plethysmography, completing a 30 s 90° abduction, external rotation (\'surrender\' position) by addition of a 15 s 90° antepulsion \'prayer\' position, allows quantitative bilateral analysis of both arterial (A-PPG) and venous (V-PPG) results. We aimed at determining the proportion of isolated arterial compression with photo-plethysmography in TOS-suspected patients.Approach.We studied 116 subjects recruited over 4 months (43.3 ± 11.8 years old, 69% females). Fingertip A-PPG and forearm V-PPG were recorded on both sides at 125 Hz and 4 Hz respectively. A-PPG was converted to PPG amplitude and expressed as percentage of resting amplitude (% rest). V-PPG was expressed as percentage of the maximal value (% max) observed during the \'Surrender-Prayer\' maneuver. Impairment of arterial inflow during the surrender (As+) or prayer (Ap+) phases were defined as a pulse-amplitude either <5% rest, or <25% rest. Incomplete venous emptying during the surrender (Vs+) or prayer (Vp+) phases were defined as V-PPG values either <70% max, or <87% max.Main results.Of the 16 possible associations of encodings, As - Vs - Ap - Vp- was the most frequent observation assumed to be a normal response. Isolated arterial inflow without venous outflow (As + Vs-) impairment in the surrender position was observed in 10.3% (95%CI: 6.7%-15.0%) to 15.1% (95%CI: 10.7%-20.4%) of limbs.Significance.Simultaneous A-PPG and V-PPG can discriminate arterial from venous compression and then potentially inter-scalene from other levels of compressions. As such, it opens new perspectives in evaluation and treatment of TOS.
摘要：
目的：在疑似胸廓出口综合征（TOS）的患者中，诊断胰岛间压迫可能导致微创治疗。在照片体积描记术期间，完成30秒90°外展,外部旋转（“投降”位置），通过增加15秒90°的前推“祈祷”位置，允许动脉（A-PPG）和静脉（V-PPG）结果的定量双侧分析。我们旨在确定TOS可疑患者中使用光电体积描记术进行孤立动脉压迫的比例。
方法：我们研究了超过4个月招募的116名受试者（43.3+/-11.8岁，69％的女性）。两侧分别以125Hz和4Hz记录指尖A-PPG和前臂V-PPG。将A-PPG转换为PPG振幅并表示为静息振幅的百分比(%静息)。V-PPG表示为“投降祈祷”操作期间观察到的最大值（％max）的百分比。在投降（As）或祈祷（Ap）阶段，动脉流入受损被定义为脉冲振幅<5％休息，或<25%休息。在投降(Vs+)或祈祷(Vp+)阶段不完全的静脉排空被定义为V-PPG值或者<70%max,或<87%最大值。
主要结果：在16种可能的编码关联中，As-Vs-Ap-Vp-是最常见的观察结果，被认为是正常反应。在上肢的10.3％[95CI：6.7-15.0％]至15.1％[95CI：10.7-20.4％]观察到孤立的动脉流入而没有静脉流出（As+Vs-）损伤。＆＃xD;意义：同时A-PPG和V-PPG可以区分动脉和静脉压迫，然后可能区分其他水平的压迫。因此，它为TOS的评估和治疗开辟了新的视角。
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