An accurate assessment is fundamental to good management.  Apart from making a diagnosis, evaluating how the underlying anatomy contributes to the symptoms and knowledge of the natural history of the condition will need to be taken into account. Therefore, how each treatment option is applied to the individual will depend on the clinical setting and result in different solutions for each patient. A particular plan may also evolve as circumstances change and the patient’s biological response become clearer.

It is important to realise that treatment is not necessarily a linear sequence nor one of escalating magnitude of intervention. It is the author’s practice to present the range of options available but to propose the most appropriate course taking into account the factors above.

The decision to proceed with treatment rests with the patient. Where surgical intervention is discussed, the surgeon’s audited results and complication profile should be discussed. In general, higher volume TOS surgeons tend to produce better results.

Contacting Us


The Small Print

Mr Colin Chan
Consultant Vascular Surgeon
Wirral University Teaching Hospital
Wirral CH49 5PE

Mrs Louise Rule
Wirral University Teaching Hospital
Wirral CH49 5PE

(+44 151 604 7530)


Spire Wirral Hospital
Holmwood Drive
Wirral CH61 1AU

(+44 151 929 5181)

Spire Manchester Hospital
170 Barlow Moor Road
Manchester M20 2AF

(+44 161 447 6600)