Highlights Neurovascular compression. Non-standardized treatment. Clinical, apparative tests.

Highlights Thoracic outlet Syndrome is a very rare disorder caused by compression of the neurovascular structures in the upper thoracic region, SAPHO Syndrom is also a rare Syndrom which causes compression of the subclavian vein in the upper thoracic region. The subclavian vein thrombosis as a complication of SAPHO syndrome is due compression caused by the Hyperostosis of the clavicle and the costoclavicular joint. In TOS, first rib resection widens the space and releases the compression on the neurovascular structures in the upper thoracic region. In the absence of a current therapy to avoid the progression of the hyperostosis of the costoclavicular joint and clavicle, the rib resection offers a surgical therapy to relieve the compression on the subclavian vein. Resection of the first rib in patients with SAPHO syndrome suffering from compression of the subclavian vein can help in avoiding more vascular damage and can relief the compression on the collateral venous circulation.