The potential use of pulse oximeters during screening for aTOS V-1.
Research type
Research Study
Full title
Assessing the potential of utilising pulse oximeter measurements during the elevated arm stress test to increase the reliability and validity of non-imaging screening for arterial thoracic outlet syndrome.
IRAS ID
346623
Contact name
Kelly Swagell
Contact email
Sponsor organisation
Imperial College London and Imperial College Healthcare NHS Trust
Duration of Study in the UK
0 years, 4 months, 1 days
Research summary
Thoracic outlet syndrome (TOS) refers to a group of conditions which involve compression of nerves, veins and arteries in the lower neck. Symptoms include pain, numbness and weakness of the arms; however, these can vary greatly amongst patients, making the syndrome difficult to diagnose.
Initial investigations into TOS include exploring the onset of symptoms in various arm positions. These are commonly carried out by a GP or physiotherapist. If arterial or venous compression is suspected, the patient is sent for an ultrasound scan of the affected blood vessels.
My project will focus on improving the accuracy of pre-imaging tests for arterial TOS. The elevated arm stress test (EAST) involves asking the patient to move both arms into a ‘surrender’ position, then to open and close their fingers for 3 minutes. The test is positive, indicating arterial compression, if the patient is unable to complete it or feels numbness in their arms/hands during the procedure. Although useful, due to its subjective nature, the EAST yields many incorrectly positive results.
Pulse oximeters measure the percentage of oxygenated blood at the finger. When blood flow to the hands is restricted, these measurements should fluctuate. Over the next year, in my department’s vascular laboratory, I will be documenting the pulse oximeter measurements of participants with and without arterial compression (confirmed using ultrasound) at rest, and during the EAST. I hypothesise that arterial TOS patients will have a significant drop in oxygen saturation during the EAST, and this will not be reproducible in patients without compression. If this is proven to be true, using pulse oximeters during the EAST should decrease the number of incorrectly positive results. Hence, the number of unnecessary ultrasound scan referrals should diminish which will free up time for vascular scientists and improve the diagnostic pathway for patients.
REC name
London - Surrey Research Ethics Committee
REC reference
24/PR/1396
Date of REC Opinion
14 Jan 2025
REC opinion
Further Information Favourable Opinion