动脉型胸廓出口综合征误漏诊分析OACSTPCD

Objective To explore the clinical characteristics and imaging manifestations,cause of misdiagnosis and missed diagnosis,and preventive measures of arterial thoracic outlet syndrome(aTOS).Methods The clinical data of 4 pa-tients with aTOS who experienced misdiagnosis and missed diagnosis and were admitted between September 2017 to September 2023 were retrospectively analyzed.Results Three patients presented with severe stenosis of the subclavian artery far from the origin of the vertebral artery,one patient presented with occlusion of the middle segment of the subclavian artery,including 2 patients who had severe stenosis of the ipsilateral axillary artery.Three patients were misdiagnosed as atherosclerotic lesions and underwent interventional treatment,and one patient was considered as having aTOS misdiagnosed due to right carotid ar-tery occlusion and received conservative treatment due to unclear clinical symptoms.One patient experienced secondary occlu-sion after two stent implantation surgeries,and ultimately underwent carotid-subclavian bypass.One patient experienced sec-ondary occlusion after stent implantation and maintained patency after balloon dilation,and one patient maintained patency af-ter undergoing stent implantation surgery.Conclusion aTOS is more likely to be misdiagnosed as atherosclerotic lesions in clinical practice.For patients with subclavian artery stenosis far from the origin of the vertebral artery or axillary artery steno-sis,aTOS should be considered.Open surgery is recommended for the treatment of aTOS.