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He stated that he and Sheldon Jordan no longer use the scalene block or Doppler ultrasound for diagnostics due to false negatives (I had a negative scalene block in 2010). Instead he uses fluoroscopic balloon angioplasty to image where compression is taking place as well as decompress those areas temporarily. It made a hell of a lot of sense to me.
He no longer holds a preferred surgical approach but plans surgery based on the angiogram. He also stated he does not always take the rib either if it is not necessary. He didn't want to talk specific details about surgical procedures until after the angiogram. I really like this vs. what I thought I knew about TOS surgery in my prior research.
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Thanks for this info. Please keep us posted. I'm suffering in Orange County as well. I find it fascinating that he uses an angio to find where the compression is. Guess it's not just a nerve problem after all --- still think the nerve compression is the primary insult and blood flow probs are secondary to that. When I had my pec minor sx, the doc wouldn't even look at my 10k MRA --- woops.