Thoracic outlet syndrome: resectioning the first rib as a last resort.

1. Thoracic outlet syndrome is a general term referring to compression neuropathies of the brachial plexus and subclavian vessels. 2. The symptoms result from compression of the brachial plexus or the subclavian vessels; the most common are pain and paresthesia but these may be accompanied by complaints of muscle weakness and easy fatigability of the extremity. 3. First rib resection has been proven valuable; however, because of the possibility of severe and irreversible complications, surgery should be used as a last resort.