Are you workers comp?
It's sounds more neurogenic the vascular. You may need to consult out of the area for the best help.
One thing that may be a start, I did not go a surgery road. For a dozen years I have has a physiatrist for maintenance. My meds, PT, etc.

I have a pain management anesthetist for trigger points and epidurals. With that help I work PT time while on disability. My TOS is a secondary injury to lumbar and sacroiliac major pain.

It means a lot goes undone, but I am not a type A or perfectionist. But, I can at least contribute to income.
Hope you find relief and answered.

Ps.the nerve pain ds had was gone from ACDF surgery for herniation, his TOS pain remains.