Just finished up with a vascular surgeon at Lahey Clinic that the orthopedic handed me off to. He acknowledged the MRA finding of the compression of the sub-clavian artery, but what was more concerning to him was his physical finding of a "thrill."

Essentially, a thrill is something you can feel on the artery upon palpation. Even I could feel it. It indicates turbulent blood flow.

In this surgeon's mind, the mere presence of the thrill has him thinking surgery without question. I clearly found this distrurbing.

I told him that my neurologic symptoms have diminished with stretching and was really hoping that TOS was on its way out. He went on to say that while the neurologic symptoms going away is good, it doesn't mean that the arterial compression has gone away. The thrill confirms this.

Has anyone else run into this? Is the presence of a thrill a key decision point in surgery or no surgery?

I've been battling symptoms for a while so it wouldn't surprise me if the artery is banged up a bit. That said, I'm shocked that therapy of some sort isn't at least being explored...especially since my neurologic symptoms have diminished so rapidly in such a short period of time. I mean, it could be that the "thrill" has diminished as well (although there's no previous data point).

Any insight here would be helpful. From what I have read, surgery to trim the scalenes is risky. If I can avoid it I'd like to exhaust all options.

Thanks.

KY