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Thoracic Outlet Syndrome pp 461–470Cite as

VTOS: Postoperative Care

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Abstract

Surgery for venous thoracic outlet syndrome (TOS) may be required for symptoms ranging from severe recalcitrant arm swelling to acute axillo-subclavian vein thrombosis. The etiology appears to be multi-factorial, involving not only mechanical compression of the subclavian vein between the anterior scalene muscle, first rib, clavicle, subclavius muscle and costoclavicular ligament, but also hematological factors such as acquired and hereditary thrombophilia. Although the visible incisions appear rather small, a sizeable operation is often required to effectively decompress the subclavian vein after clot dissolution. Such surgery and the associated need for postoperative anticoagulation carry a number of risks and considerations. Attention to the many details of successfully helping a patient recover through first rib resection and postoperative care is required for an ultimately successful outcome. This chapter is intended to describe the general approach used in our institution for venous TOS and includes historical considerations and data supporting some of the surgical and medical decision-making.

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Authors and Affiliations

  1. Division for Vascular Surgery, Stroobants Heart Center, Centra Lynchburg General Hospital, 1901 Tate Springs Road, Lynchburg, VA, 24501, USA

    David C. Cassada MD, FACS

Authors
  1. David C. Cassada MD, FACS
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Corresponding author

Correspondence to David C. Cassada MD, FACS .

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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Cassada, D.C. (2013). VTOS: Postoperative Care. 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_66

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  • DOI: https://doi.org/10.1007/978-1-4471-4366-6_66

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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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