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Botulinum Toxin Type A Improves Blood Flow in Vascular Thoracic Outlet Syndrome

Danielson, Kirk MD; Odderson, Ib R. MD, PhD

American Journal of Physical Medicine & Rehabilitation: November 2008 - Volume 87 - Issue 11 - p 956-959
doi: 10.1097/PHM.0b013e31818a51c3
Case report: Vascular

Danielson K, Odderson IR: Botulinum toxin type a improves blood flow in vascular thoracic outlet syndrome. Am J Phys Med Rehabil 2008;87:956–959.

A 28-yr-old man, diagnosed with vascular thoracic outlet syndrome, had his right anterior scalene muscle injected with botulinum toxin type A under ultrasound guidance. Subclavian artery flow rates were measured with Doppler ultrasound before and 3 wks after the injection. At 3 wks, symptoms had improved. The reduction in subclavian artery flow rate associated with the arm abducted to the side with 90-degree external rotation decreased from 132.8 to 87.7 cm/sec preinjection compared with a smaller decrease postinjection from 132.8 to 119.1 cm/sec. An improved subclavian artery flow was seen after scalene muscle chemodenervation for vascular thoracic outlet syndrome. This suggests its potential as a diagnostic test, treatment option, and predictor for surgical intervention.

From the Department of Rehabilitation Medicine, University of Washington Medical Center, Seattle, Washington.

All correspondence and requests for reprints should be addressed to Ib R. Odderson, MD, PhD, Department of Rehabilitation Medicine, Box 356490, 1959 NE Pacific St., Seattle, WA 98195.

No external funding for this article was provided. Ib R. Odderson, MD, PhD, receives honoraria and serves on the advisory committees for Allergan, Inc. and Solstice Neurosciences, Inc.

© 2008 Lippincott Williams & Wilkins, Inc.