Abstract
When treating a patient with venous thoracic outlet syndrome (VTOS), the most critical structures are the anterior part of the first rib, the anterior part of the clavicle, and the associated subclavius muscle and costoclavicular tendon connecting the two – the costoclavicular junction. The transaxillary exposure provides the best exposure of the anterior first rib, subclavius muscle, and costoclavicular tendon, yields excellent exposure of the entire subclavian vein to the level of the jugular vein, allows thorough circumferential external venolysis, and is most cosmetically attractive for patients, many of whom are in a young, active age group. When combined with thrombolysis and performed with proper technique for effort thrombosis, complications, most commonly hematoma, asymptomatic small pneumothorax, and temporarily troubling but temporary long thoracic nerve injury, should be rare, and long-term success achieved in over 90 % of patients treated.
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Illig, K.A. (2013). Surgical Techniques: Operative Decompression Using the Transaxillary Approach for 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_61
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DOI: https://doi.org/10.1007/978-1-4471-4366-6_61
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