International collaborative · est. 2026
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.
Start here
Membership is open to clinicians and researchers involved in TOS care. Applications are reviewed by the membership committee.
Propose a multicenter study, request registry data, or join a study that is already recruiting centers.
Lectures, operative videos, imaging protocols and diagnostic algorithms, indexed by topic and reviewed by the education committee.
One anatomical corridor, three diseases
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.
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.
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.
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.
Latest news
Fifty-two panellists from nineteen countries will rate 34 statements on positional imaging, duplex protocols and reporting thresholds across three anonymous rounds.
Read the announcement →Thirty-eight participating centers have now contributed structured records covering presentation, imaging, intervention and twelve-month outcome.
Read the update →Six annotated procedures with narrated decision points, added to the members’ education library with downloadable operative checklists.
Read the update →Find a TOS center
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.
Membership
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.