Which population is most commonly affected by arterial TOS?

• A. Older women with sedentary lifestyle
• B. Younger men with vigorous arm activity
• C. Children with congenital anomalies
• D. Middle-aged adults with obesity

Answer: (B)

Arterial thoracic outlet syndrome most often shows up in younger, physically active men who perform repetitive overhead arm movements. The arterial form arises from compression of the subclavian artery, which is more likely in people whose work or sport involves rapid arm elevation and sustained shoulder girdle effort, especially if there is an anatomical predisposition like a cervical rib or scalene muscle hypertrophy. In contrast, older sedentary individuals, children with congenital anomalies, or middle-aged adults with obesity fit less with the typical pattern for arterial TOS, as they are not the group in which vascular compression due to repetitive arm activity is most common.