If you've seen all those other surgeons confirming A and/or V TOS, are you not seeing them to follow your case? I know that, personally, I was not at all impressed with the Yale surgeons. I was not at all convinced they knew what they were talking about and they were happy to give me a diagnosis of TOS without anything further than one provocative test. I thought I only had NTOS but when I later went to another doctor for a second opinion it was found that I had AVNTOS.
That being said, Mass General is extremely well-respected for TOS diagnosis and if you can go there, that's really where I would recommend that you be.
Like you, I keloid like crazy. I was told that they would not do steroid injections to prevent the formation of keloids because the chest area is notorious for not healing very well and he didn't want to risk me not being able to heal from my surgery when the scars could (hopefully) be managed with good post-op care, a watchful eye, and physical therapy. I had surgery and my scar looks great after making sure to massage it regularly and apply breast milk to it. If you want to see a picture, head over to my thread "bilateral transsternal first rib resection."
Anyway, don't allow the local guy to do your surgery. He doesn't sound like he knows a thing of what he's talking about and I have no respect for a doctor that goes outside their area of knowledge. A vascular surgeon, simply, can't read a CT scan like a radiologist can.
That being said, vascular surgeons are the normal ones to take care of NTOS surgically. Neurosurgeons typically don't even believe that TOS exists and they do not do the surgery because they are not able to cut bone whereas a vascular surgeon can. Sometimes, TOS decompression surgery requires the cutting of bone such as in my case where I had 2 ribs removed.
Hope that helped!