Abstract
Acute axillosubclavian vein thrombosis is a disorder of the anterior thoracic outlet and can be associated with anatomic abnormalities such as occult first rib fracture, abnormal venous or bony anatomy and an abnormally lateral insertion of the costoclavicular ligament. With repetitive overhead activity the subclavian vein sustains continuous damage from mechanical compression. Over time, intraluminal and extraluminal scarring progresses, blood flow becomes impaired and collaterals form to compensate. Acute occlusion results from occlusion of the subclavian vein itself or of the collaterals. Prompt thrombolysis followed by thoracic outlet decompression leads to excellent results. Balloon venoplasty and venous stenting should not be used as primary long-term treatment strategies as untreated mechanical compression will result in recurrent venous occlusion and stent fracture.
Revision of prior chapter by Harold C. Urschel Jr. MD, J. Mark Pool MD, and Amit N Patel MD.
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Audu, C.O., Vemuri, C., Urschel, H.C., Pool, J.M., Patel, A.N. (2021). Anatomy and Pathophysiology of Venous Thoracic Outlet Syndrome. In: Illig, K.A., et al. Thoracic Outlet Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-030-55073-8_53
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