Hi all.

My teenaged son was just diagnosed with bilateral arterial TOS.

We are told he is simply "unlucky" to have this, when we ask why/what caused it. He had no trauma such as car accident, and he does not have a cervical rib per a chest x-ray. The diagnosis a A/TOS was made by Doppler ultrasound finding positional complete compression of the subclavian artery and subsequent venogram.

The vascular surgeon says he needs decompression surgery that includes removing the first rib, right side first as that is his more symptomatic side.

From I what am reading, the vast majority of A/TOS patients have a cervical rib causing the A/TOS. According to chest x-ray, my son does not have any cervical ribs. It just seems logical to me that the precise cause should be identifiable before surgery is attempted, so that surgery will actually fix the problem, or am I incorrect? Is "too crowded" sometimes the only cause? Are there other tests I should ask for?

Thanks.