Thoracic Outlet Syndrome (TOS) Sydney

Thoracic Outlet Syndrome (TOS) refers to a group of conditions caused by compression of the brachial plexus nerves or the subclavian blood vessels (artery and/or vein) as they pass through the thoracic outlet — the space between the collarbone and first rib.

Thoracic Outlet Syndrome may affect nerves, arteries, veins, or a combination of these structures, leading to a wide range of symptoms involving the neck, shoulder, arm, and hand.

Types of Thoracic Outlet Syndrome

There are three main types of Thoracic Outlet Syndrome:

Arterial Thoracic Outlet Syndrome (ATOS)
Compression of the subclavian artery.
Venous Thoracic Outlet Syndrome (VTOS)
Compression of the subclavian vein.
Neurogenic Thoracic Outlet Syndrome (NTOS)
Compression of the brachial plexus nerves.

Symptoms of Thoracic Outlet Syndrome

Symptoms vary depending on whether nerves or blood vessels are affected.

Neurogenic TOS Symptoms

Neck, shoulder, and arm pain
Numbness or tingling in the hand and fingers
Arm weakness or fatigue
Heaviness during overhead arm activity
Reduced grip strength

Venous TOS Symptoms

Sudden arm swelling
Bluish discoloration of the arm
Arm heaviness and pain
Subclavian vein thrombosis (Paget–Schroetter syndrome)

Arterial TOS Symptoms

Cold or pale fingers
Hand pain during activity
Reduced blood flow to the hand
Finger embolisation
Subclavian artery aneurysm or arterial compression

Causes of Thoracic Outlet Syndrome

The thoracic outlet is a naturally confined anatomical space. Certain anatomical variations or repetitive movements may increase pressure on nearby nerves and blood vessels.

Common causes include:

Cervical ribs
Abnormal or rudimentary first ribs
Scalene muscle hypertrophy
Variations in surrounding muscles or ligaments
Previous trauma or injury
Repetitive overhead activity or heavy lifting

Athletes and individuals performing repetitive arm elevation may be at increased risk of developing Thoracic Outlet Syndrome.

Diagnosis of Thoracic Outlet Syndrome

Accurate diagnosis requires careful clinical assessment by an experienced vascular surgeon, as symptoms can overlap with cervical spine, shoulder, or neurological conditions.

Assessment may include:

Detailed vascular and neurological examination
Duplex vascular ultrasound
CT angiography or MR angiography
Venography or arterial imaging
Nerve conduction studies where appropriate

Thoracic Outlet Syndrome Treatment Sydney

Treatment depends on the type and severity of Thoracic Outlet Syndrome.

Conservative Treatment

Many patients may benefit from:

Physiotherapy
Postural correction
Activity modification
Pain management strategies

Surgical Treatment

In selected patients with arterial or venous compression, thoracic outlet decompression surgery may be recommended.

Surgical treatment may include:

First rib resection
Scalenectomy
Thoracic outlet decompression
Subclavian vein decompression
Arterial or venous reconstruction where required

Why Choose Dr Igor Banzic for Thoracic Outlet Syndrome in Sydney?

Specialist vascular surgeon with expertise in arterial and venous Thoracic Outlet Syndrome
Comprehensive vascular assessment and advanced imaging
Experience performing thoracic outlet decompression and vascular reconstruction procedures
Minimally invasive and open surgical treatment options
Consulting and operating across multiple Sydney hospitals
Individualised treatment planning focused on long-term outcomes

Thoracic Outlet Syndrome Specialist Sydney

Dr Igor Banzic provides specialist assessment and surgical management of Thoracic Outlet Syndrome across multiple hospitals in Sydney. His practice focuses on the diagnosis and treatment of arterial and venous Thoracic Outlet Syndrome, including thoracic outlet decompression, first rib resection, scalenectomy, and vascular reconstruction where required.