Initial conservative (nonsurgical) management of the thoracic outlet syndrome may include all of the following except:

D. Pentoxifylline.

DISCUSSION: The initial management of the thoracic outlet syndrome is nonoperative. A trial of weight reduction, shoulder girdle strengthening exercises, improvement of posture, and avoidance of hyperabduction should be recommended for 4 months or longer. These measures are successful in 50% to 70% of patients, particularly in young to middle-aged females with poor posture. Pentoxifylline is a hemorrheologic agent used in selected patients with peripheral arterial insufficiency and has no known benefit in the thoracic outlet syndrome.