NEWS | August 7, 2014

UC Davis launches a clinic to treat thoracic outlet syndrome


UC Davis Health System has opened a clinic dedicated to treating a rare and complex condition called thoracic outlet syndrome (TOS), which occurs when blood vessels or nerves running from the upper body through the arm become compressed, causing problems ranging from reduced mobility and pain to life- and limb-threatening blood clots. It is most often the outcome of trauma, repetitive movements or extra ribs that are present at birth.

Julie Freischlag Julie Freischlag

The clinic is led by Julie Freischlag who, in addition to being an internationally recognized vascular surgeon and TOS expert, is vice chancellor for Human Health Sciences and dean of the School of Medicine at UC Davis. Freischlag is known for advancing a surgical treatment for TOS that involves removing the anterior scalene muscle in the neck and first rib through an incision in the armpit to reduce compression and restore use of the limbs. 

The procedure helped one of the clinic’s first patients, Amy Leach, who experienced ongoing pain, swelling and tiredness for years following an automobile accident that broke her neck and ribs. As part of a comprehensive exam, Leach was asked to hold her hands above her head and move her fingers for two minutes. One hand turned white — a sign of limited circulation and distinguishing feature of TOS.

Leach’s symptoms significantly improved following her surgery on July 3.

“I feel unbelievably different, not just in my arm but overall, too,” she said. “Simple, everyday tasks that were extremely difficult are now possible and my energy is returning. I’m having a hard time pacing myself as I recover.”

One of Freischlag’s goals is to conduct education sessions to help physicians identify different forms of TOS. Patients with nerve-related TOS can go years without a correct diagnosis, because the symptoms mimic orthopaedic conditions of the neck, spine and shoulder. Vascular TOS, which causes swelling, reduced blood supply and clots, is an acute condition that requires urgent intervention.

The new clinic links UC Davis experts from vascular surgery, pain medicine, and physical medicine and rehabilitation in providing complete evaluations, customized treatment planning and care for TOS patients. The health system’s telehealth network will support diagnosis and follow-up evaluations and reduce travel for patients who live outside of the region.

“UC Davis’ interprofessional collaboration in patient care combined with its education focus and the expertise of its vascular center make it an ideal fit for a clinic dedicated to thoracic outlet syndrome,” said Freischlag. “Our commitment to research and discovery also means that we will be launching clinical trials to help us continue to refine treatments for these patients.”

In addition to Freischlag, the clinic team includes co-director and vascular surgeon Misty Humphries, other vascular center specialists and nurse Shirley Daffin. Evaluations are scheduled at the UC Davis Vascular Center in Sacramento, Calif., and can be requested by calling 1-800-4-UCDAVIS (1-800-482-3284) and selecting option 2.

UC Davis Health System improves lives by providing excellent patient care, conducting groundbreaking research, fostering innovative education and creating dynamic, productive community partnerships. It encompasses one of the country’s best medical schools, a 619-bed acute-care teaching hospital, a 1,000-member physician practice group and the Betty Irene Moore School of Nursing. Together, they make UC Davis a hub of innovation that is transforming health for all. For information, visit