I would love a 2nd opinion since my vascular surgeon told me that I need surgery. I asked what my other options were and he said point blank "nothing". I do not have an extra cervical rib, my 1st and 2nd ribs don't "stay down" and he wants to remove the 1st rib and do a scalenectomy. I just don't know about this but I don't know of any other vascular surgeons in Pittsburgh that deal with TOS.