Having ATOS does not guarantee you will need surgery. I was diagnosed with bilateral ATOS in the middle of 2012 w/ complete occlusion of subclavian artery bilaterally.

For me, I was completely unwilling to have surgery. Prior to developing TOS I was VERY active (5+ days per week at gym and/or playing basketball). My desire to eventually return to these activities made surgery a non-option.

Anyways, I'm currently recovering at what I consider a moderate pace. I'm back in the gym with a modified routine as well as playing some light sports. Progress is painfully slow compared to recovering from an injury. Staying positive and progressing at the pace your body allows is important.

Surgery should be a last resort. When an individual reaches that point varies from individual to individual.