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- Abed Rahman, Albaraa Hamid, Konstantin Inozemtsev, and Andrew Nam.
- From the Department of Anesthesiology, John H. Stroger Cook County Hospital, Chicago, Illinois.
- A A Pract. 2019 Apr 1; 12 (7): 235-237.
AbstractThoracic outlet compression syndrome is a complex syndrome of neurovascular compression at the superior thoracic aperture, thought to occur at 1 of 3 anatomical compartments: the interscalene triangle, the costoclavicular space, and the retropectoralis minor space. Injection into the middle interscalene muscle (ISM) and/or pectoralis muscle plane (PECS I and II) is gaining popularity because it provides significant symptomatic relief. A 44-year-old woman was diagnosed with thoracic outlet compression syndrome, with failed conservative therapy, including physical therapy. She refused surgical intervention. ISM and PECS I and II blocks with botulinum toxin type A were successful. In combination, PECS I/II and ISM injections can provide excellent symptomatic relief.
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