Diseases of Aortic Arch Vessels and thoracic outlet syndroma.

Atherosclerosis is the most common cause of Aortic Arch Vessels diseases. Less common are dissection, embolization, compressive syndromes of the upper thoracic outlet, and various types of arteritis (Takayasu, giant cell arteritis etc.). Left subclavicular artery is most commonly affected. Due to anatomical reasons, chronical stenosans and occlusive lesions of major arterial branches often stay asymptomatic and therefore undiagnosed for a long period of time. It is not a rare case that lesions of supraaortic branches are presented by the gangrene in certain parts of hand. Good anamnesis is of huge importance, as well as careful physical examination, which requires radial pulse palpation in normal and provoked positions. The term Thoracic Outlet Syndrome (TOS) is represented as a group of neurological and vascular syndromes on the upper extremity caused by compression on brachial plexus and subclavicular vessels by the bone or soft tissue structures which abnormally compress nerves or blood vessels exiting the thoracal cavity. The aim of this study is to remind physicians in the primary health care of the simplicity of physical diagnostics of these diseases and of the great advantage of timely consultation with a vascular surgeon.