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Venous thoracic outlet syndrome

MedGen UID:
408326
•Concept ID:
C1956396
•
Disease or Syndrome
Synonym: Venous Thoracic Outlet Syndrome
SNOMED CT: Venous thoracic outlet syndrome (25981000119102); Paget Schrotter disease (25981000119102); Venous cervical rib syndrome (25981000119102); Effort subclavian vein thrombosis (25981000119102)
 
Monarch Initiative: MONDO:0018165
Orphanet: ORPHA357131

Definition

A form of thoracic outlet syndrome that manifests as unilateral (rarely bilateral) arm pain and cyanosis. The disease occurs in young adults, usually after excessive arm activity. The characteristic symptoms, caused by venous obstruction, are arm swelling, cyanosis and pain. Repetitive arm motion and compression of the subclavian vein in the neck (between the clavicle and the first rib) leads to scar tissue that can predispose to thrombosis due to narrowing of vessels. [from SNOMEDCT_US]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVVenous thoracic outlet syndrome

Professional guidelines

PubMed

Management of Paget-Schroetter Syndrome: a Systematic Review and Meta-Analysis.
Hoexum F, Hoebink M, Coveliers HME, Wisselink W, Jongkind V, Yeung KK
Eur J Vasc Endovasc Surg 2023 Dec;66(6):866-875. Epub 2023 Sep 6 doi: 10.1016/j.ejvs.2023.08.065. PMID: 37678659
Evaluation and Management of Venous Thoracic Outlet Syndrome.
Cook JR, Thompson RW
Thorac Surg Clin 2021 Feb;31(1):27-44. doi: 10.1016/j.thorsurg.2020.08.012. PMID: 33220769
ACR Appropriateness Criteria® Thoracic Outlet Syndrome.
Expert Panels on Vascular Imaging, Thoracic Imaging, and Neurological Imaging, Zurkiya O, Ganguli S, Kalva SP, Chung JH, Shah LM, Majdalany BS, Bykowski J, Carter BW, Chandra A, Collins JD, Gunn AJ, Kendi AT, Khaja MS, Liebeskind DS, Maldonado F, Obara P, Sutphin PD, Tong BC, Vijay K, Corey AS, Kanne JP, Dill KE
J Am Coll Radiol 2020 May;17(5S):S323-S334. doi: 10.1016/j.jacr.2020.01.029. PMID: 32370976

Recent clinical studies

Etiology

Venous compression syndromes in females: A descriptive review.
Ozsvath K, Raffetto JD, Lindner E, Murphy EH
Semin Vasc Surg 2023 Dec;36(4):550-559. Epub 2023 Oct 20 doi: 10.1053/j.semvascsurg.2023.10.006. PMID: 38030329
A review of upper extremity deep vein thrombosis.
Khan O, Marmaro A, Cohen DA
Postgrad Med 2021 Aug;133(sup1):3-10. Epub 2021 Mar 8 doi: 10.1080/00325481.2021.1892390. PMID: 33618595
Paget-Schroetter syndrome: A contemporary review of the controversies in management.
Cai TY, Rajendran S, Saha P, Dubenec S
Phlebology 2020 Aug;35(7):461-471. Epub 2020 Feb 6 doi: 10.1177/0268355519898920. PMID: 32028850
Intravascular Ultrasound in Venous Thoracic Outlet Syndrome.
Kim TI, Sarac TP, Orion KC
Ann Vasc Surg 2019 Jan;54:118-122. Epub 2018 Sep 11 doi: 10.1016/j.avsg.2018.08.077. PMID: 30217714
McCleery syndrome: etiology and outcome.
Likes K, Rochlin DH, Call D, Freischlag JA
Vasc Endovascular Surg 2014 Feb;48(2):106-10. Epub 2013 Dec 12 doi: 10.1177/1538574413512380. PMID: 24334914

Diagnosis

A review of upper extremity deep vein thrombosis.
Khan O, Marmaro A, Cohen DA
Postgrad Med 2021 Aug;133(sup1):3-10. Epub 2021 Mar 8 doi: 10.1080/00325481.2021.1892390. PMID: 33618595
Evaluation and Management of Venous Thoracic Outlet Syndrome.
Cook JR, Thompson RW
Thorac Surg Clin 2021 Feb;31(1):27-44. doi: 10.1016/j.thorsurg.2020.08.012. PMID: 33220769
Vascular Thoracic Outlet Syndrome.
Hussain MA, Aljabri B, Al-Omran M
Semin Thorac Cardiovasc Surg 2016 Spring;28(1):151-7. Epub 2015 Oct 28 doi: 10.1053/j.semtcvs.2015.10.008. PMID: 27568153
Venous thoracic outlet syndrome.
Moore R, Wei Lum Y
Vasc Med 2015 Apr;20(2):182-9. doi: 10.1177/1358863X14568704. PMID: 25832605
The Paget-Schroetter syndrome.
Feugier P, Chevalier JM
Acta Chir Belg 2005 May-Jun;105(3):256-64. doi: 10.1080/00015458.2005.11679713. PMID: 16018517

Therapy

The infraclavicular approach for venous thoracic outlet syndrome.
Loh SA, Tonnessen BH
Semin Vasc Surg 2024 Mar;37(1):74-81. Epub 2024 Jan 28 doi: 10.1053/j.semvascsurg.2024.01.003. PMID: 38704187
Paget-Schroetter syndrome: A contemporary review of the controversies in management.
Cai TY, Rajendran S, Saha P, Dubenec S
Phlebology 2020 Aug;35(7):461-471. Epub 2020 Feb 6 doi: 10.1177/0268355519898920. PMID: 32028850
Conservative management of chronic upper extremity venous outflow occlusion.
Brooke BS
Phlebology 2016 Mar;31(1 Suppl):34-40. doi: 10.1177/0268355516631860. PMID: 26916767
Venous thoracic outlet syndrome: approach to diagnosis and treatment with focus on affected athletes.
Farrar TA, Rankin G, Chatfield M
Curr Sports Med Rep 2014 Mar-Apr;13(2):81-5. doi: 10.1249/JSR.0000000000000035. PMID: 24614420
The Paget-Schroetter syndrome.
Feugier P, Chevalier JM
Acta Chir Belg 2005 May-Jun;105(3):256-64. doi: 10.1080/00015458.2005.11679713. PMID: 16018517

Prognosis

Thoracic outlet decompression for subclavian venous stenosis after ipsilateral hemodialysis access creation.
Lim S, Alarhayem AQ, Rowse JW, Caputo FJ, Smolock CJ, Lyden SP, Kirksey L, Hardy DM
J Vasc Surg Venous Lymphat Disord 2021 Nov;9(6):1473-1478. Epub 2021 Mar 3 doi: 10.1016/j.jvsv.2021.02.010. PMID: 33676044
How Common Is Thoracic Outlet Syndrome?
Illig KA, Rodriguez-Zoppi E
Thorac Surg Clin 2021 Feb;31(1):11-17. doi: 10.1016/j.thorsurg.2020.09.001. PMID: 33220767
Intravascular Ultrasound in Venous Thoracic Outlet Syndrome.
Kim TI, Sarac TP, Orion KC
Ann Vasc Surg 2019 Jan;54:118-122. Epub 2018 Sep 11 doi: 10.1016/j.avsg.2018.08.077. PMID: 30217714
Venous thoracic outlet syndrome.
Moore R, Wei Lum Y
Vasc Med 2015 Apr;20(2):182-9. doi: 10.1177/1358863X14568704. PMID: 25832605
The Paget-Schroetter syndrome.
Feugier P, Chevalier JM
Acta Chir Belg 2005 May-Jun;105(3):256-64. doi: 10.1080/00015458.2005.11679713. PMID: 16018517

Clinical prediction guides

A review of upper extremity deep vein thrombosis.
Khan O, Marmaro A, Cohen DA
Postgrad Med 2021 Aug;133(sup1):3-10. Epub 2021 Mar 8 doi: 10.1080/00325481.2021.1892390. PMID: 33618595
Surgical management of post-thrombotic syndrome in chronic venous thoracic outlet syndrome.
Pesser N, Bode A, Goeteyn J, Hendriks J, van Nuenen BFL, Illig KA, van Sambeek MRHM, Teijink JAW
J Vasc Surg Venous Lymphat Disord 2021 Sep;9(5):1159-1167.e2. Epub 2021 Jan 8 doi: 10.1016/j.jvsv.2020.12.079. PMID: 33429091
Intravascular Ultrasound in Venous Thoracic Outlet Syndrome.
Kim TI, Sarac TP, Orion KC
Ann Vasc Surg 2019 Jan;54:118-122. Epub 2018 Sep 11 doi: 10.1016/j.avsg.2018.08.077. PMID: 30217714
Vascular Thoracic Outlet Syndrome.
Hussain MA, Aljabri B, Al-Omran M
Semin Thorac Cardiovasc Surg 2016 Spring;28(1):151-7. Epub 2015 Oct 28 doi: 10.1053/j.semtcvs.2015.10.008. PMID: 27568153
Venous thoracic outlet syndrome.
Moore R, Wei Lum Y
Vasc Med 2015 Apr;20(2):182-9. doi: 10.1177/1358863X14568704. PMID: 25832605

Recent systematic reviews

Management of Paget-Schroetter Syndrome: a Systematic Review and Meta-Analysis.
Hoexum F, Hoebink M, Coveliers HME, Wisselink W, Jongkind V, Yeung KK
Eur J Vasc Endovasc Surg 2023 Dec;66(6):866-875. Epub 2023 Sep 6 doi: 10.1016/j.ejvs.2023.08.065. PMID: 37678659

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