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Anatomy and Pathophysiology of VTOS

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Thoracic Outlet Syndrome

Abstract

Acute axillosubclavian vein thrombosis is a disorder of the anterior thoracic outlet, and is always associated with an abnormally lateral insertion of the costoclavicular ligament. This is a low pressure system associated with extrinsic compressive forces, and conventional intraluminal therapy designed to treat atherosclerotic arterial lesions is not appropriate in this situation. In our experience of over 600 extremities with this condition, prompt thrombolysis followed by thoracic outlet decompression leads to excellent results in over 95 % of patients, especially if treatment is instituted soon after thrombosis occurs.

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Acknowledgment

The contribution of Mrs. Rachel Montano and Mrs. Brenda Knee are of immeasurable value for her dedication and commitment to the research and completion of this publication.

Author information

Authors and Affiliations

  1. Department of Cardiovascular and Thoracic Surgery, Baylor University Medical Center, University of Texas Southwestern Medical School, 3600 Gaston Ave, Ste. 1201, Dallas, TX, 75246, USA

    Harold C. Urschel Jr. MD

  2. Department of Cardiac, Vascular and Thoracic Surgical Associates, Texas Health Presbyterian Hospital of Dallas, 8230 Walnut Hill Lane, Suite 208, Dallas, TX, 75231, USA

    J. Mark Pool MD

  3. Department of Cardiothoracic Surgery, School of Medicine, The University of Utah, 30 North, 1900 East, Suite 3C127, Salt Lake City, UT, 84132, USA

    Amit N. Patel MD

Authors
  1. Harold C. Urschel Jr. MD
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  2. J. Mark Pool MD
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  3. Amit N. Patel MD
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Corresponding author

Correspondence to Harold C. Urschel Jr. 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

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© 2013 Springer-Verlag London

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Urschel, H.C., Pool, J.M., Patel, A.N. (2013). Anatomy and Pathophysiology of VTOS. 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_49

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  • DOI: https://doi.org/10.1007/978-1-4471-4366-6_49

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4365-9

  • Online ISBN: 978-1-4471-4366-6

  • eBook Packages: MedicineMedicine (R0)

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