I would encourage you to follow your gut. I wish I had.

I had surgery 8 years ago for mostly neurogenic TOS but I also had vascular involvement (demonstrated in various studies). I never returned to work as an attorney. My life is infinitely smaller than it was before the surgery. Perhaps this progression of pain would have happened without surgery but I'll never know.

In my experience, the surgeons understate the potential for problems and overstate "success." My surgeon in San Francisco, who does 2-3 of these surgeries each week, said I had an 85% chance of getting better, but he couldn't say how much better. Either he is overstating his success or I was just one of the unlucky people making up the dreaded 15%. I thought 85% going into surgery was pretty good odds; I didn't consider that I would be in the 15%.

Take stock of where you are. If you can manage the symptoms, is that better than potentially being dependent upon opioids, unable to work or exercise, with much higher pain and headache (unfortunately, that has been my experience).
I don't say this to scare you or because I am anti-surgery in all cases. But it's a big surgery and I think patients should go in with their eyes open, especially if they are not experiencing much distress presently. As others have said, the analysis is completely different if you have blood clots.

Good luck with your decision.

Kelly