Evaluation and Management of Venous Thoracic Outlet Syndrome

Jason R. Cook, Robert W. Thompson

Research output: Contribution to journalReview articlepeer-review

Abstract

Venous thoracic outlet syndrome (TOS) is uncommon but occurs in young, healthy patients, typically presenting as subclavian vein (SCV) effort thrombosis. Venous TOS arises through chronic repetitive compression injury of the SCV in the costoclavicular space with progressive venous scarring, focal stenosis, and eventual thrombosis. Diagnosis is evident on clinical presentation with sudden spontaneous upper extremity swelling and cyanotic discoloration. Initial treatment includes anticoagulation, venography, and pharmacomechanical thrombolysis. Surgical management using paraclavicular decompression can result in relief from arm swelling, freedom from long-term anticoagulation, and a return to unrestricted upper extremity activity in more than 90% of patients.

Original languageEnglish (US)
Pages (from-to)27-44
Number of pages18
JournalThoracic Surgery Clinics
Volume31
Issue number1
DOIs
StatePublished - Feb 1 2021

Keywords

  • Axillary-subclavian vein effort thrombosis
  • Duplex ultrasound
  • Paget-Schroetter syndrome
  • Surgical techniques
  • Surgical treatment
  • Thrombolysis
  • Vein reconstruction
  • Venography

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine

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