Did the doctor explain why he didn't think surgery would work or help? In everything I've read, it seems like people with vascular symptoms often benefit the most from surgery. Did he comment on whether the surgery would reduce your chance of clotting in the future? I think it may be worth getting a second opinion if possible. From my own experience and reading what others have gone through, it seems like each surgeon has a different take on TOS and treatment, even down to how they perform surgery and what they remove.