Thoracic outlet syndrome: a 50-year experience at Baylor University Medical Center
Harold C. Urschel, Jr., MDcorresponding author and Harry Kourlis, Jr., MD
From the Department of Thoracic and Cardiovascular Surgery, Baylor University Medical Center, Dallas, Texas.

Corresponding author: Harold C. Urschel, Jr., MD, Chair of Cardiovascular and Thoracic Surgical Research, Education, and Clinical Excellence, Baylor University Medical Center, 3600 Gaston Avenue, Suite 1201, Dallas, Texas 75246 (e-mail: drurschel@earthlink.net).
Small right arrow pointing to: See commentary "Invited commentary" on page 135.
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>Abstract
{you can click on these topics on the website- good info}
A PERSONAL INTEREST
HISTORICAL NOTE
SURGICAL ANATOMY
NERVE COMPRESSION
DIAGNOSIS
UPPER PLEXUS VS LOWER PLEXUS
ARTERIAL COMPRESSION
SYMPATHETIC NERVE COMPRESSION
SURGICAL APPROACHES FOR DORSAL SYMPATHECTOMY
PSEUDOANGINA
VENOUS COMPRESSION
RECURRENT THORACIC OUTLET SYNDROME
RECURRENT ARTERIAL ABNORMALITIES
MORTALITY AND MORBIDITY RATES
RESULTS
Acknowledgment
References

Abstract
During the past 5 decades, the recognition and management of thoracic outlet syndrome (TOS) have evolved. This article elucidates these changes and improvements in the diagnosis and management of TOS at Baylor University Medical Center. The most remarkable change over the past 50 years is the use of nerve conduction velocity to diagnose and monitor patients with nerve compression. Recognition that procedures such as breast implantation and median sternotomy may produce TOS has been revealing. Prompt thrombolysis followed by surgical venous decompression for Paget-Schroetter syndrome has markedly improved results compared with the conservative anticoagulation approach; thrombolysis and prompt first rib resection is the optimal treatment for most patients with Paget-Schroetter syndrome. Complete first rib extirpation at the initial procedure markedly reduces the incidence of recurrent neurologic symptoms or the need for a second procedure. Chest pain or pseudoangina can be caused by TOS. Dorsal sympathectomy is helpful for patients with sympathetic maintained pain syndrome or causalgia and patients with recurrent TOS symptoms who need a second procedure.

Use the link and go to the site - explore the side tabs on the left.
I skimmed thru it and some nice information there.

http://www.pubmedcentral.nih.gov/art...9872#id2595089