Thoracic Outlet Syndrome International Collaborative Contact Find a TOS center

International collaborative · est. 2026

One narrow passage. Three distinct diseases.

TOSIC brings together the surgeons, neurologists, radiologists, physiotherapists and researchers who treat thoracic outlet syndrome, so that diagnosis, treatment and reporting follow the same standard wherever the patient is seen.

38
TOS centers
21
Countries
1,240
Registry cases
6
Consensus projects
Schematic of the thoracic outlet A stylised drawing showing the clavicle, first rib, scalene muscles and pectoralis minor, with the brachial plexus, subclavian artery and subclavian vein passing through the three compression spaces. 1 2 3 MIDDLE SCALENE ANTERIOR SCALENE PECTORALIS MINOR Brachial plexus Subclavian artery Subclavian vein Clavicle / first rib
1 Interscalene triangle  ·  2 Costoclavicular space  ·  3 Retropectoralis minor space  ·  schematic, not to scale

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One anatomical corridor, three diseases

Neurogenic, venous and arterial TOS behave differently — and are still reported as if they were one condition.

Everything the collaborative publishes — registry fields, case discussions, consensus statements and education — is separated along these three lines, so that data from one center can be compared with data from another.

Neurogenic

Brachial plexus compression

By far the most common form. Pain, paraesthesia and weakness in the arm and hand, typically worse with overhead or sustained activity. Diagnosis rests on history, examination and the exclusion of other causes rather than on a single test.

Venous

Subclavian vein compression

Presents with arm swelling, heaviness and bluish discolouration, often after repetitive effort. May develop into effort thrombosis (Paget–Schroetter syndrome), where the timing of thrombolysis and decompression is decisive.

Arterial

Subclavian artery compression

The least common and the most urgent. Usually associated with a bony anomaly such as a cervical rib, and may present with ischaemia, coldness, claudication of the arm or distal embolisation.

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Find a TOS center

Thirty-eight centers, twenty-one countries, one directory.

Every listed center has been reviewed by the collaborative and publishes its team, services and contact details. Patients and referring physicians can search the map directly; centers can apply to be listed.

Where TOS centers are listed A world map with a marker on each city where a center in the TOSIC directory is based. The full, searchable map is on the Find a Center page. Stockholm London Amsterdam Berlin Paris Milan Istanbul Erbil Dubai Toronto New York St Louis Sao Paulo Cape Town Tokyo Sydney

Membership

Membership is free while the collaborative is being established.

Members gain the private document library, case discussions, the member directory, the education library, research participation and a downloadable membership certificate. Applications are reviewed individually.