Skip to main content
SpringerLink
Log in

Controversies in VTOS: What to Do About the Contralateral Side?

  • Chapter
  • First Online:
Thoracic Outlet Syndrome

  • 3238 Accesses

Abstract

Very little information is available regarding the natural history of the contralateral side in patients with venous TOS (VTOS). Despite the sparse data, some conclusions can be drawn – patients with VTOS do appear to be at an increased risk of developing contralateral VTOS, and abnormal venographic findings on the contralateral side are common in patients with VTOS. Asymptomatic venous stenosis with positional obstruction can progress to symptomatic venous obstruction, but the rate at which this occurs is not known. Screening for contralateral pathology is reasonable in patients with VTOS (interviews alone, with imaging reserved for only those with active symptoms), prophylactic surgery on the contralateral side is not indicated, and, lastly, the same principals used in treating primary VTOS should be applied when considering VTOS on the contralateral side.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 189.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Adams J, McEvoy R, DeWeese J. Primary deep venous thrombosis of upper extremity. Arch Surg. 1965;91:29–42.

    Article  Google Scholar 

  2. Falconer M, Weddell G. Costoclavicular compression of subclavian artery and vein. Lancet. 1943;2:539.

    Article  Google Scholar 

  3. Gould P, Patey D. Primary thrombosis of axillary vein: study of eight cases. Br J Surg. 1928;16:208.

    Article  Google Scholar 

  4. McCleery RS, Kesterson JE, Kirtley JA, Love RB. Subclavius and anterior scalene muscle compression as a cause of intermittent obstruction of the subclavian vein. Ann Surg. 1951;1335:588–602.

    Article  Google Scholar 

  5. Sampson J, Saunders JB, Capp CS. Compression of the subclavian vein by first rib and clavicle. Am Heart J. 1940;19:292.

    Article  Google Scholar 

  6. Azakie A, McElhinney DB, Thompson RW, Raven RB, Messina LM, Stoney RJ. Surgical management of subclavian-vein effort thrombosis as a result of thoracic outlet compression. J Vasc Surg. 1998;28(5):777–86.

    Article  PubMed  CAS  Google Scholar 

  7. Feugier P, Aleksic I, Salari R, Durand X, Chevalier JM. Long-term results of venous revascularization for Paget-Schroetter syndrome in athletes. Ann Vasc Surg. 2001;15(2):212–18.

    Article  PubMed  CAS  Google Scholar 

  8. Urschel Jr HC, Razzuk MA. Improved management of the Paget-Schroetter syndrome secondary to thoracic outlet compression. Ann Thorac Surg. 1991;52(6):1217–21.

    Article  PubMed  Google Scholar 

  9. Adams J, DeWeese J, Mahoney E, Rob C. Intermittent subclavian vein obstruction without thrombosis. Surgery. 1968;68:147–65.

    Google Scholar 

  10. Juvonen T, Satta J, Laitala P, Luukkonen K, Nissinen J. Anomalies at the thoracic outlet are frequent in the general population. Am J Surg. 1995;170(1):33–7.

    Article  PubMed  CAS  Google Scholar 

  11. Tanaka Y, Aoki M, Izumi T, Fujimiya M, Yamashita T, Imai T. Measurement of subclavicular pressure on the subclavian artery and brachial plexus in the costoclavicular space during provocative positioning for thoracic outlet syndrome. J Orthop Sci. 2010;15(1):118–24.

    Article  PubMed  Google Scholar 

  12. Heron E, Lozinguez O, Emmerich J, Laurian C, Fiessinger JN. Long-term sequelae of spontaneous axillary-subclavian venous thrombosis. Ann Intern Med. 1999;131(7):510–13.

    Article  PubMed  CAS  Google Scholar 

  13. Urschel Jr HC, Razzuk MA. Paget-Schroetter syndrome: what is the best management? Ann Thorac Surg. 2000;69(6):1663–8; discussion 1668–9.

    Article  PubMed  Google Scholar 

  14. Illig KA, Doyle AJ. A comprehensive review of Paget-Schroetter syndrome. J Vasc Surg. 2010;51(6):1538–47.

    Article  PubMed  Google Scholar 

  15. Green RM, Waldman D, Ouriel K, Riggs P, Deweese JA. Claviculectomy for subclavian venous repair: long-term functional results. J Vasc Surg. 2000;32(2):315–21.

    Article  PubMed  CAS  Google Scholar 

  16. Hempel GK, Shutze WP, Anderson JF, Bukhari HI. 770 consecutive supraclavicular first rib resections for thoracic outlet syndrome. Ann Vasc Surg. 1996;10(5):456–63.

    Article  PubMed  CAS  Google Scholar 

  17. Adelman MA, Stone DH, Riles TS, Lamparello PJ, Giangola G, Rosen RJ. A multidisciplinary approach to the treatment of Paget-Schroetter syndrome. Ann Vasc Surg. 1997;11(2):149–54.

    Article  PubMed  CAS  Google Scholar 

  18. Sheeran SR, Hallisey MJ, Murphy TP, Faberman RS, Sherman S. Local thrombolytic therapy as part of a multidisciplinary approach to acute axillosubclavian vein thrombosis (Paget-Schroetter syndrome). J Vasc Interv Radiol. 1997;8(2):253–60.

    Article  PubMed  CAS  Google Scholar 

  19. Lee MC, Grassi CJ, Belkin M, Mannick JA, Whittemore AD, Donaldson MC. Early operative intervention after thrombolytic therapy for primary subclavian vein thrombosis: an effective treatment approach. J Vasc Surg. 1998;27(6):1101–7; discussion 1107–8.

    Article  PubMed  CAS  Google Scholar 

  20. Angle N, Gelabert HA, Farooq MM, et al. Safety and efficacy of early surgical decompression of the thoracic outlet for Paget-Schroetter syndrome. Ann Vasc Surg. 2001;15(1):37–42.

    PubMed  CAS  Google Scholar 

  21. Coletta JM, Murray JD, Reeves TR, et al. Vascular thoracic outlet syndrome: successful outcomes with multimodal therapy. Cardiovasc Surg. 2001;9(1):11–5.

    Article  PubMed  CAS  Google Scholar 

  22. Kreienberg PB, Chang BB, Darling 3rd RC, et al. Long-term results in patients treated with thrombolysis, thoracic inlet decompression, and subclavian vein stenting for Paget-Schroetter syndrome. J Vasc Surg. 2001;33(2 Suppl):S100–5.

    Article  PubMed  CAS  Google Scholar 

  23. Lokanathan R, Salvian AJ, Chen JC, Morris C, Taylor DC, Hsiang YN. Outcome after thrombolysis and selective thoracic outlet decompression for primary axillary vein thrombosis. J Vasc Surg. 2001;33(4):783–8.

    Article  PubMed  CAS  Google Scholar 

  24. Schneider DB, Dimuzio PJ, Martin ND, et al. Combination treatment of venous thoracic outlet syndrome: open surgical decompression and intraoperative angioplasty. J Vasc Surg. 2004;40(4):599–603.

    Article  PubMed  Google Scholar 

  25. Lee JT, Karwowski JK, Harris EJ, Haukoos JS, Olcott C. Long-term thrombotic recurrence after nonoperative management of Paget-Schroetter syndrome. J Vasc Surg. 2006;43(6):1236–43.

    Article  PubMed  Google Scholar 

  26. Molina JE, Hunter DW, Dietz CA. Paget-Schroetter syndrome treated with thrombolytics and immediate surgery. J Vasc Surg. 2007;45(2):328–34.

    Article  PubMed  Google Scholar 

  27. Urschel Jr HC, Patel AN. Surgery remains the most effective treatment for Paget-Schroetter syndrome: 50 years’ experience. Ann Thorac Surg. 2008;86(1):254–60; discussion 260.

    Article  PubMed  Google Scholar 

  28. Guzzo JL, Chang K, Demos J, Black JH, Freischlag JA. Preoperative thrombolysis and venoplasty affords no benefit in patency following first rib resection and scalenectomy for subacute and chronic subclavian vein thrombosis. J Vasc Surg. 2010;52(3):658–63.

    Article  PubMed  Google Scholar 

  29. Stone DH, Scali ST, Bjerk AA, et al. Aggressive treatment of idiopathic axillo-subclavian vein thrombosis provides excellent long-term function. J Vasc Surg. 2010;52(1):127–31.

    Article  PubMed  Google Scholar 

  30. Thakur S, Comerota AJ. Bilateral nonthrombotic subclavian vein obstruction causing upper extremity venous claudication. J Vasc Surg. 2010;52(1):208–11.

    Article  PubMed  Google Scholar 

  31. Doyle A. Venous thoracic outlet syndrome. Rochester: University of Rochester Medical Center; 2011.

    Google Scholar 

  32. Hurley WL, Comins SA, Green RM, Canizzaro J. Atraumatic subclavian vein thrombosis in a collegiate baseball player: a case report. J Athl Train. 2006;41(2):198–200.

    PubMed  Google Scholar 

  33. Lindblad B, Tengborn L, Bergqvist D. Deep vein thrombosis of the axillary-subclavian veins: epidemiologic data, effects of different types of treatment and late sequelae. Eur J Vasc Surg. 1988;2(3):161–5.

    Article  PubMed  CAS  Google Scholar 

  34. Machleder HI. Evaluation of a new treatment strategy for Paget-Schroetter syndrome: spontaneous thrombosis of the axillary-subclavian vein. J Vasc Surg. 1993;17(2):305–15; discussion 316–7.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, University of Rochester Medical Center, 601 Elmwood Ave Box SURG, Rochester, NY, 14642, USA

    Adam J. Doyle MD

Authors
  1. Adam J. Doyle MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Adam J. Doyle MD .

Editor information

Editors and Affiliations

  1. , Division of Vascular Surgery, University of South Florida, Tampa General Circle, STC 7016 2, Tampa, 33606, Florida, USA

    Karl A. Illig

  2. Barnes-Jewish Hospital, Department of Surgery, Washington University, Queeny Tower Campus Box, St. Louis, 63110, Missouri, USA

    Robert W. Thompson

  3. , Department of Surgery, John Hopkins Medical Institutions, Rutland Avenue - Ross 759 729, Baltimore, 21205, Maryland, USA

    Julie Ann Freischlag

  4. , Department of Thoracic Surgery, Blake 15, Massachusetts General Hospital, Fruit Street 55, Boston, 02114, Massachusetts, USA

    Dean M. Donahue

  5. Neurological Associates of West LA, Wilshire Blvd, Suite 790 2811, Santa Monica, 90403, California, USA

    Sheldon E. Jordan

  6. , Graduate Program in Physical Therapy, UCSF/SFSU, Balmoral Street 2429, Union City, 94587, California, USA

    Peter I. Edgelow

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag London

About this chapter

Cite this chapter

Doyle, A.J. (2013). Controversies in VTOS: What to Do About the Contralateral Side?. In: Illig, K., Thompson, R., Freischlag, J., Donahue, D., Jordan, S., Edgelow, P. (eds) Thoracic Outlet Syndrome. Springer, London. https://doi.org/10.1007/978-1-4471-4366-6_76

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-4366-6_76

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4365-9

  • Online ISBN: 978-1-4471-4366-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation