Thoracic Outlet Decompression  

Thoracic outlet decompression relieves pressure on blood vessels and nerves just below the collarbone.  The thoracic outlet is a ring-shaped space located just below the collarbone and above the ribs. When one of the blood vessels or nerves that run through this area becomes pinched, thoracic outlet decompression surgery may be recommended to relieve pressure on the affected structure.  

Conditions Treated 

Thoracic outlet decompression is a surgical treatment option for thoracic outlet syndrome—a condition that occurs when a rib, muscle, scar tissue or the clavicle bone presses against a blood vessel or nerve. This can result from an anatomic abnormality that is present at birth (congenital) or from factors like:  

• Injuries, such as whiplash  
• Poor posture 
• Bodybuilding that focuses on neck and chest muscles  
• Weight gain   
• Frequent overhead motions, such as those involved in painting a ceiling or throwing a baseball   

The symptoms of thoracic outlet syndrome will depend on whether a vein, nerve or artery is compressed and to what extent. Generally speaking, signs of this condition include:  

• Arm pain, weakness, tingling or numbness   
• An arm or hand that appears bluish  
• Swelling in the arm, hand or fingers  
• An unusually pale or cold hand  

Procedure Details 

Thoracic outlet decompression is performed under general anesthesia in a hospital setting. The details of the procedure will vary according to whether a blood vessel or nerve is compressed, what it is compressed by and its specific location within the thoracic outlet. Generally speaking, though, surgery involves:  

• Making an incision above the clavicle bone, under the arm or on the chest  
• Removing the top rib, scare tissue, muscle or another structure that is pressing against the vessel or nerve  
• Repairing damaged blood vessels, if necessary 
• Closing the incision with stitches  

What to Expect 

Thoracic outlet decompression requires a one- to three-day hospital stay, during which the patient’s vitals will be closely monitored and pain medication may be given as needed. Most patients can resume normal, low-impact activities following surgery, although a regimen of physical therapy may be recommended to facilitate healing and improve arm strength.   

Effectiveness  

Many people with thoracic outlet syndrome find relief from symptoms through nonsurgical methods like physical therapy, medication and injection therapies. However, thoracic outlet decompression surgery is often appropriate for patients whose symptoms do not improve with conservative treatments. Following surgery, most patients report positive results and improved quality of life.   

Tampa General Hospital features a diverse team of vascular surgeons, thoracic surgeons, neurologists and other experts who help patients with thoracic outlet syndrome achieve world-class outcomes through personalized care and leading-edge techniques.