The thoracic outlet syndrome is a prevalent entity. Most cases respond to conservative methods of therapy. Surgical decompression, when necessary, is effective in the majority of cases, and morbidity and mortality are low. The diagnosis of thoracic outlet compression syndrome is usually made on the basis of an adequate history and physical examination. Neuroelectric studies are inconsistently helpful. The predominant symptoms are neuro logic, not vascular. Pulse obliteration does indicate some element of anatomic tightness. However, without symptom reproduction, pulse change has no diagnostic relationship to thoracic outlet syndrome. Conversely, the inability to obliterate or diminish the radial pulse in positions of thoracic outlet tightness, when symptoms are reproduced in those positions, has no corre lation to the results of decompression.
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