Meet the NeoVista® Team

We care

We often hear the question, “why do you spend so much time and effort on thoracic outlet syndrome?” The answer is simple: we care about our thoracic outlet syndrome patients. It is easy to see how the diagnosis of thoracic outlet syndrome affects the lives of patients and their families. We believe we can help. We are thoracic outlet syndrome specialists.

We also care about the thoracic outlet syndrome patients we haven’t yet met, and the thoracic outlet syndrome patients we might never meet. We aim to move forward thoracic outlet syndrome awareness, understanding, and the availability of care for all future thoracic outlet syndrome patients.



Availability of Care

Meat the Team

Awareness of TOS

After patients develop thoracic outlet syndrome symptoms, they often follow one of two pathways. Firstly, if they are lucky, they find a doctor knowledgeable about TOS, a true thoracic outlet syndrome specialist. This specialist makes the correct diagnosis of thoracic outlet syndrome and the patient starts appropriate treatment for thoracic outlet syndrome. Secondly, if unlucky, the patient might visit a number of doctors, one after the other. These doctors may not understand or be aware of the symptoms of thoracic outlet syndrome or the diagnosis of thoracic outlet syndrome. Thus, the patient develops worsening symptoms of thoracic outlet syndrome, without appropriate treatment.

In the latter case, patients often try to help themselves. They might search for online help, often unable to find a unifying diagnosis. How many patients have heard the term, ‘thoracic outlet syndrome?’ We often wonder how a thoracic outlet syndrome patient would know how to search for this disease?

Furthermore, have you ever searched for ‘arm pain,’ ‘neck pain,’ or ‘shoulder pain?’ If so, you have become inundated with a large number of broad and non-specific diagnoses. It is hard to imagine how a patient could help themselves with this broad information.

So, our first goal is to raise awareness of thoracic outlet syndrome. Firstly, we want patients to hear the name enough to have a basic understanding of the symptoms of thoracic outlet syndrome and the causes of thoracic outlet syndrome. Even if a patient hasn’t heard about thoracic outlet syndrome, hopefully a family member, co-worker, neighbor, or parent will have.

Second, we realize that many physicians do not recognize the symptoms of thoracic outlet syndrome. If we successfully raise awareness of thoracic outlet syndrome, we hope to see growth in the number of thoracic outlet syndrome specialists. Since we hear many stories from thoracic outlet syndrome patients about their search for a physician who recognizes and diagnoses thoracic outlet syndrome, there is room for improvement.

We travel across the country to speak with physicians about TOS. Interestingly, many physicians simply do not know enough about the disease or have experience diagnosing thoracic outlet syndrome to feel comfortable. Now they have a resource for information.

We spend a lot of time communicating with thoracic outlet syndrome patients and their families. In general, they ask for thoracic outlet syndrome education resources to learn more on their own. Frequently, they also ask about a local thoracic outlet syndrome specialist. We are happy to help patients find a local or regional thoracic outlet syndrome specialist.

So our third important goal is to build networks to connect thoracic outlet syndrome patients and thoracic outlet syndrome specialists. Read more below.

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Understanding of TOS

TOS is complex. We get that. We know a lot of doctors don’t ‘believe’ in TOS. Still other doctors don’t feel comfortable treating or diagnosing thoracic outlet syndrome. Even among the thoracic outlet syndrome specialists who regularly diagnose and treat thoracic outlet syndrome patients, we see a fair amount of variability in treatment of thoracic outlet syndrome.

So TOS is a complex disease with an emotional overlay and professional disagreements. Obviously, the best step forward for patients and thoracic outlet syndrome specialists is to learn more and to have ongoing healthy and productive discussions.

Towards this goal, we have designed our website to provide thoracic outlet syndrome education. To begin with, our visitors can take basic thoracic outlet syndrome anatomy lessons. Then, visitors can walk through the underlying causes of thoracic outlet syndrome. Additionally, visitors can view detailed graphics and images. We know these can assist in visualizing the complex anatomy and complex disease we know as thoracic outlet syndrome.

In the long run, we aim to grow knowledge and understanding of TOS for all interested patients and thoracic outlet syndrome specialists. Not only do we wish to share our understanding and progress, but also to help spread advancements from all experts. Additionally, we target consistency. Thoracic outlet syndrome diagnosis and thoracic outlet syndrome treatment should not be decided by city, state or institution. Each TOS patient should receive the same diagnosis and treatment.

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Availability of TOS Care

We hear from many patients of their difficulties getting the correct diagnosis of TOS. Even for patients with an accurate diagnosis, many cannot find good treatment choices. We understand, patients in pain have less strength to fight a difficult system.

Our third goal is to make TOS care available to everybody that needs it. No hassles, no arguments, no delays. We intend to see quick and accurate diagnosis, great treatment plans, and choices for TOS patients and their families. This care should be available and easy to find in every city. Every physician who sees TOS patients should recognize the disease, and be willing and able to refer these patients to experienced specialists. And every patient should be able to find a physician who can help. 

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Do you have questions about thoracic outlet syndrome?

We can help!

Meet the NeoVista® Team

We may be small, but we are dedicated, motivated, and serious about TOS.

NeoVista® team Scott Werden, MD Medical Director

Scott Werden, MD

Radiology and Internal Medicine

Scott Werden, MD

I am the founder and medical director of Vanguard Specialty Imaging. I invented the NeoVista MRI examination for patients with TOS. At present, I hold three patents for this work.

I trained at SUNY Stony Brook, Duke University, Boston University, Mallinckrodt Institute of Radiology, and Johns Hopkins. After training, I achieved board certification in both internal medicine and diagnostic radiology. Since 1998, I have practiced radiology in the San Francisco Bay area.

I saw my first TOS patient in 2003. In a moment, I became intrigued with learning more about the disease and helping TOS patients. Since then, I have studied over 2000 TOS patients with my unique MRI examination.

I speak on TOS at national meetings, and in community and university Grand Rounds. I served as a board member for the country’s largest TOS Patient Advocacy Group.  I participated on the steering committee of a national multi-center grant application to the National Institutes of Health. I authored the chapter on MRI of TOS for the state of the art textbook on TOS.

I devote much of my clinical practice and energy to TOS. For one thing, I greatly enjoy outreach with TOS patients and their providers. Further, I am an active and perpetual student of TOS. I teach myself, and then reach out to expand awareness and knowledge of the disease to patients and physicians. I founded the NeoVista® Multi-specialty Group, and the Thoracic Outlet Society, a group dedicated to the study of TOS.

TOS is my passion. I deeply enjoy expanding TOS knowledge, helping patients, raising awareness, and providing doctors the best TOS diagnostic and treatment tools. Each and every patient success brings me tremendous professional and personal satisfaction.

NeoVista® team Herb Repp Operations Manager

Herb Repp

Marketing and Sales Leader

Herb Repp

I have been with Vanguard Specialty Imaging virtually from its inception.  I understand the barriers that patients with TOS face when seeking care for this diagnosis.  This awareness drives me to seek solutions to improve care for these motivated patients.  

I founded my own healthcare consulting company, Vision United Associates, in 2003. Before this, I learned over a 5-year stint with a large, national health care organization. My areas of competence include relationship development, employee education and training, transition management, sales team and program development and market analysis and positioning. I  developed and implemented numerous successful marketing and physician outreach teams and campaigns. My efforts have enhanced many outpatient imaging center and physician specialty clinic clients. These range from large organizations like Insight Health to high-profile institutions like Lucille Packard Children’s Hospital. I have managed teams large and small and provided leadership for multiple consumer-facing healthcare web launches. My central vision for Vision United Associates is to enable and empower health care providers. I bring this vision forward through concerted marketing and physician relations outreach effort.

I aim to use my broad experience and skillset to empower TOS patients and physicians. To begin with, I understand the tremendous growth potential and the current challenges for TOS patients and doctors. At the same time, I relish the opportunity to help so many people recover their full health.

I spend my free time doing  yoga, hiking, traveling, reading, or stargazing with my family.

Symptoms of Thoracic Outlet Syndrome

Do you have pain, numbness, tingling or weakness? Click to learn more about the symptoms of thoracic outlet syndrome.

Diagnosis of Thoracic Outlet Syndrome

Click to learn how thoracic outlet syndrome specialists examine a TOS patient and select thoracic outlet syndrome tests.

Treatment of Thoracic Outlet Syndrome

Different types of thoracic outlet syndrome require different treatment. Click to learn about your treatment choices