Infraclavicular thoracic outlet decompression compared to supraclavicular thoracic outlet decompression for the management of venous thoracic outlet syndrome

Upper extremity deep vein thrombosis (DVT) results from pathologic compression of the subclavian vein at the costoclavicular junction.1-3 Also known as Paget-Schroetter syndrome, this pathology is associated with high morbidity and severe symptoms.2-5 The military population is particularly susceptible given the prevalence of young, healthy service members performing rigorous physical activity and training. Our group has previously reported significant functional recovery following supraclavicular decompression for neurogenic thoracic outlet syndrome (NTOS) in the high-performance military population.
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Clinical Research, Basic Science Source Type: research

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ConclusionsDuplex ultrasound has significant limitations in the initial evaluation of patients with suspected SCV thrombosis, with false-negative results in 21% of patients with proven VTOS. This is rarely acknowledged in ultrasound reports, but false-negative ultrasound studies have the potential to delay definitive imaging, thrombolysis, and further treatment for VTOS. Initial false-negative ultrasound results are associated with progressive thrombus extension and a more frequent need for SCV bypass reconstruction at the time of surgical treatment.Graphical Abstract
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
The objective of this study was to assess the use and consequences of upper extremity duplex ultrasound (U/S) in the initial diagnostic evaluation of patients with suspected subclavian vein (SCV) thrombosis and venous thoracic outlet syndrome (VTOS).
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Abstract from the 2019 Midwestern Vascular Surgical Society Annual Meeting Source Type: research
ConclusionsKey conditions including upper extremity and lower extremity venous thrombosis, venous aneurysms, Paget-Schroetter syndrome (effort thrombosis), and popliteal vein entrapment syndrome are discussed. Further studies evaluating long-term outcomes on morbidity for current treatment regimens in upper extremity DVT, effort thrombosis, venous thoracic outlet syndrome, and popliteal venous entrapment syndrome are required.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
ConclusionsIn our experience, venous bypass combined with thoracic outlet decompression achieves symptomatic relief in approximately 90% of patients with symptomatic upper extremity central venous occlusion, with morbidity limited to the perioperative period.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
Publication date: Available online 22 January 2019Source: Surgery (Oxford)Author(s): Frank CT. Smith, Rebecca J. WinterbornAbstractThoracic outlet syndrome (TOS) consists of a group of distinct pathologies arising as a result of compression of structures at the thoracic outlet. The structures at risk are, from anterior to posterior, the subclavian vein, subclavian artery and brachial plexus. Compression or impingement causes venous (VTOS), arterial (ATOS) or neurogenic (NTOS) TOS. NTOS is the most common presentation, caused by compression of the brachial plexus at the scalene triangle or pectoralis minor space. Other comp...
Source: Surgery (Oxford) - Category: Surgery Source Type: research
In conclusion, the infraclavicular route may have significant advantages compared with the transaxillary or supraclavicular approaches for successful and durable treatment of Paget-Schroetter syndrome. PMID: 29388461 [PubMed - in process]
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Tags: Ann R Coll Surg Engl Source Type: research
In this report, we describe a 56-year-old man with primary UEDVT presenting with left arm swelling, paresthesia, and visible collateral veins around the shoulder. Venography revealed thrombotic occlusion of the left subclavian vein. Emergent pharmaco-mechanical catheter-directed thrombolysis (PCDT) was performed, and his left subclavian vein was recanalized. A novel oral anticoagulant was initiated to prevent reclosure. The patient’s symptoms subsided without major bleeding complications and at six months, he has no disability for daily activities. Follow-up ultrasonography revealed almost complete patency of the lef...
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research
Short quiz on DVT Quiz on DVT Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Congratulations - you have completed Quiz on DVT. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%% Your answers are highlighted below. Question 1Risk factor/s for upper limb venous thrombosis:AVigorous arm exerciseBCentral venous catheterCPacemaker / d...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
This study analyzed the staged endovascular and surgical management (SESM) of axillosubclavian deep venous thrombosis caused by Paget-Schroetter syndrome (PSS).
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Abstract from the 2016 New England Society for Vascular Surgery Annual Meeting Source Type: research
Publication date: October 2016 Source:Journal of Vascular Surgery: Venous and Lymphatic Disorders, Volume 4, Issue 4 Author(s): Chandu Vemuri, Payam Salehi, Jaime Benarroch-Gampel, Lauren N. McLaughlin, Robert W. Thompson Venous thoracic outlet syndrome (VTOS) is uncommon but most frequently occurs in young, active, healthy patients. This condition typically presents as subclavian vein (SCV) effort thrombosis, also known as Paget-Schroetter syndrome. The pathophysiology underlying VTOS is chronic repetitive compression injury of the SCV in the costoclavicular space, resulting in progressive venous scarring, focal ste...
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
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