Hello. I am writing because my daughter was diagonosed with thoracic outlet syndrome after a swollen right arm resulted from clots forming in her shoulder due to the compression on the subclavican vein. After dissolving the clots, (she has been on coumeden for 4 months) her vascular surgeon informed us that she needs to have the first rib removed. Since then, we have received conflicting advice on whether she really needs to have the surgery or not, and who is better qualified to do it - a vascualar or orthopedic surgeon. Needless to say we are both very confused. She lives in Atlanta and we don't know how to go about finding the best doctor there to do this procedure. Since most of you have probably done tons of research on this, any advice you can give would be greatly appreciated. Thanks.