Thoracic outlet compression: Application of positional arteriographic and nerve conduction studies

Positional arteriography has not proved to be of significant assistance in the evaluation of patients with thoracic outlet compression and should be reserved for those patients presenting with an obvious arterial problem such as aneurysm, obstruction, or embolic phenomena. Positional ulnar nerve conduction times were positive in 88 per cent of all patients operated on for thoracic outlet compression. Patients with normal neutral and elevated velocities through the outlet should be approached cautiously from a surgical standpoint. We believe that positional ulnar nerve conduction times are a desirable addition to the diagnostic armamentarium of the physician evaluating the patient presenting with symptoms and signs of the thoracic outlet compression syndrome.