Residual first rib resection aided by partial second rib resection in the treatment of recurrent thoracic outlet syndrome

Abstract

Thoracic outlet syndrome (TOS) describes compression of the neurovascular bundle of the brachial plexus, subclavian artery, and/or subclavian vein as they leave the thoracic outlet. A 40-year-old female with history of thoracic outlet syndrome status-post left first rib resection presented in 2021 with symptoms of recurrent TOS due to the presence of a residual first rib. A transaxillary approach was performed and a partial second rib resection was required to remove the residual first rib. At 4½-month follow-up, there was improvement in all symptoms.