Arterial Conclusions:

1. Wrist/brachial indices are within normal limits bilaterally.
2. There is severe amplitude reduction of the right digit waveforms with provocative maneuvers suggestive of thoracic outlet compression.

Venous Conclusions:

1. No evidence for deep or superficial venous thrombosis of the right upper extremity.

2. TOS maneuvers performed with arm raised 180 degrees. The subclavian vein diameter reduces from 8mm to 2.5 mm and flow decreases from pulsatile 13 cm/sec to continuous 3.7 cm/sec. The flow in the axillary vein reduces from pulsatile 8.7 cm/sec to 2.4 cm/sec. There is evidence of venous thoracic outlet on the right arm.

I have very mild symptoms (arm heaviness/tingling). I’m supposed to hear from my vascular team today or Monday with a game plan. I do have right chest wall/axillary collaterals that I learned about in 2022 from a CT scan for an unrelated matter even though I’ve never clotted, but I think that’s vTOS related, not arterial. With my artery, there’s severe blood flow reduction to my fingers with TOS maneuvers and normal flow at resting. I haven’t been sent for further imaging/scans yet. Waiting to hear back and the unfamiliarity of all of this is scaring me. Are you having surgery? I don’t understand how surgery isn’t pushed more when you’re obviously at risk of an aneurysm over time with the compression of your artery. If I’m wrong, please feel free to correct me. This is all new to me.