Subclavine artery compression, any one else
 

I just got back from the hospital. Which they ran. Abunch of test using all the brand new equipment they just got which turned out great for me as I already went through a rib resection on one of the video images they took they could clearly see my subclavein artery was being completely pinched off, they actually called in a bunch of doctors from the. Imaging department to show them my compression as they have never seen one so bad my blood.pressure and pulse went right to zero with my arm at my side. And just turned my head to the opposite side, has any one else had tos surgery for the subclavein artery and what was your outcome. I am very tired of all the pain with today and CRPS I just want to go back to work, suffering in Canada.

My subclavian artery was being severely compressed. I have done many months of PT and it is no longer being compressed. Have you tried good PT?

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.

this is insane! i am jealous

i think i have nerve compression in that area..do you ahve any guesses on how it released the compression?

I have had only scalenectomy for subclavian artery compression with exactly same symptoms as yours and I am doing great on right side(2002). I was also perfect on left side after scalenectomy (2010) till scar tissue built up after 10 months post surgery and I am working on PT exercises and really good manual PT is helping me. Good news is that it is easier to fix the vascular issues than the neural issues, because the arterial compression shows in the fallout in the subclavian artery in the MRA and/or Doppler ultrasound and they can see it quite clearly. You might have bands compressing your subclavian artery. (Bands are however hard to see in imaging till the surgeon goes in.)Has to be done by a good vascular surgeon who does quite a few of these. They usually do an MRA after surgery too to see if the blood is flowing properly before they close you up.
I did months of PT before the surgeries but PT was not helping me. I am so glad I had those surgeries, because too much compression can lead to an aneurysm in the artery if it is serious compression. Sorry I am not trying to scare you. Please get a second opinion if you can and then decide.

I would think it would be from balancing the muscles that form/maintain the thoracic outlet. Which is why it is important to have an experienced/knowledgeable PT/OT person.

It is good to hear that vascular is easier to fix but I hear it also the most serious , yes it is on the same side from my surgery. Ten months ago after a rib resection, but which suck's is I also have the neurological. Type tos as well and rsd, do not know what they are going to do next but getting tired of it all the pain, the chest pains, turning blue, no sports all because my employer. Never fixed a commercial freezer door that yanked my arm with over 3000 pounds of force all well and ideas what they are going to do next thanks for your earlier post suffering in canada

Arterial fix is usually not so serious if the surgeon has lots of practice and is just good with his/her hands. Neurological can be fixed with really good PT who knows TOS well. I couldn't do stretches or nerve glides, but now I can because first my PT did rib work on me, that is fixing the foundation and doing myofascial release before making me do any exercises.
Now I can do most of the exercises and stretches and nerve glides that I couldn't do before with other PT's. My PT is Dr. Art Ando at Ando and Aston, Anaheim hills CA.

RSD & TOS is a very tough combination. You need some very knowledgeable drs & therapists to get the best care.

Have you read on our RSD forum also?
There are a few members there with the TOS/RSD combo.

I have really tight outlet and thus compression...I had to have stenosed Sub clav addressed. At time surgeon commented that the overall size of my vessels is markedly smaller than the norm ( oh to be normal!). Post re do surg on left side and stenosis addressed I do have better blood flow but still can pinch vessel of in certain positions. I have lots of spasm and lovely colour changes in hands. Tis all fun...Basically need to weigh up options carefully and respond to condition accordingly.
Best wishes all...Happy Halloween:grouphug: