I've already had the surgery done on the other side but this was for neurogenic TOS so they could see a difference between the two sides with my vascular studies. The operated side has great blood flow. I couldn't tell from your post if you're having blood flow problems on the side that you already had surgery on or if the blood flow problem is on the other side.

Your imaging results sound slightly worse than mine. I still had some (very little) blood flow with the arm at the side of the body. It became non-existent with slight elevation of the arm and definitely non-existent for the maneuvers they test. I know I had good blood flow in these positions 9 years ago when I first dealt with TOS on the other side. I injured this side 4 years ago and had shoulder surgery for a torn labrum in hopes of not triggering TOS on this side. I attempted several rounds of physical therapy and other conservative treatment over the last 4 years. I had the vascular testing done several times during the past 4 years and it was progressively worsening. With the most recent results (flatlining,severe stenosis of the artery), they did not advise conservative treatment anymore. I saw several surgeons and even contemplated going out of state. In the end, I stayed with my original surgeon who did the other side 8 years ago. I had surgery earlier this year and the surgeon immediately saw why it was so bad. It would not have improved with conservative treatment. My arm feels so good now.

Your CRPS complicates the situation. What are the doctors advising you? People with arterial and venous TOS tend to fare better with surgery but this outcome likely depends on surgeon skill, extent of damage inside, patient, etc. Given you've already had this surgery, you know what to expect in recovery. I have to say even though I knew what to expect with surgery and outcome, my experience the 2nd time around was way different.