Controversies in VTOS: Is There Ever a Role for Venous Stents in VTOS?
The bony venous thoracic outlet creates significant extrinsic force upon the subclavian vein, and intravascular stents in this location thus perform very poorly. There is some literature supporting the use of stents after decompression, but no level I evidence exists. At present the use of stents in venous thoracic outlet syndrome should not be considered until the bony thoracic outlet has been decompressed, and even then should be reserved for isolated cases with thorough followup.
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