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Venous thoracic outlet syndrome

MedGen UID:
408326
•Concept ID:
C1956396
•
Disease or Syndrome
Synonym: Venous Thoracic Outlet Syndrome
SNOMED CT: Venous thoracic outlet syndrome (25981000119102); Paget Schrotter disease (25981000119102); Venous cervical rib syndrome (25981000119102); Effort subclavian vein thrombosis (25981000119102)
 
Monarch Initiative: MONDO:0018165
Orphanet: ORPHA357131

Definition

A form of thoracic outlet syndrome that manifests as unilateral (rarely bilateral) arm pain and cyanosis. The disease occurs in young adults, usually after excessive arm activity. The characteristic symptoms, caused by venous obstruction, are arm swelling, cyanosis and pain. Repetitive arm motion and compression of the subclavian vein in the neck (between the clavicle and the first rib) leads to scar tissue that can predispose to thrombosis due to narrowing of vessels. [from SNOMEDCT_US]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVVenous thoracic outlet syndrome

Professional guidelines

PubMed

Management of Paget-Schroetter Syndrome: a Systematic Review and Meta-Analysis.
Hoexum F, Hoebink M, Coveliers HME, Wisselink W, Jongkind V, Yeung KK
Eur J Vasc Endovasc Surg 2023 Dec;66(6):866-875. Epub 2023 Sep 6 doi: 10.1016/j.ejvs.2023.08.065. PMID: 37678659
Evaluation and Management of Venous Thoracic Outlet Syndrome.
Cook JR, Thompson RW
Thorac Surg Clin 2021 Feb;31(1):27-44. doi: 10.1016/j.thorsurg.2020.08.012. PMID: 33220769
ACR Appropriateness Criteria® Thoracic Outlet Syndrome.
Expert Panels on Vascular Imaging, Thoracic Imaging, and Neurological Imaging, Zurkiya O, Ganguli S, Kalva SP, Chung JH, Shah LM, Majdalany BS, Bykowski J, Carter BW, Chandra A, Collins JD, Gunn AJ, Kendi AT, Khaja MS, Liebeskind DS, Maldonado F, Obara P, Sutphin PD, Tong BC, Vijay K, Corey AS, Kanne JP, Dill KE
J Am Coll Radiol 2020 May;17(5S):S323-S334. doi: 10.1016/j.jacr.2020.01.029. PMID: 32370976

Recent clinical studies

Etiology

Venous compression syndromes in females: A descriptive review.
Ozsvath K, Raffetto JD, Lindner E, Murphy EH
Semin Vasc Surg 2023 Dec;36(4):550-559. Epub 2023 Oct 20 doi: 10.1053/j.semvascsurg.2023.10.006. PMID: 38030329
Hybrid Paraclavicular Decompression for Venous Thoracic Outlet Syndrome with Primary Endovascular Reconstruction.
Miciura AL, Napier JA, Aziz A
Ann Vasc Surg 2023 Oct;96:335-346. Epub 2023 Apr 10 doi: 10.1016/j.avsg.2023.03.016. PMID: 37040840
A review of upper extremity deep vein thrombosis.
Khan O, Marmaro A, Cohen DA
Postgrad Med 2021 Aug;133(sup1):3-10. Epub 2021 Mar 8 doi: 10.1080/00325481.2021.1892390. PMID: 33618595
Paget-Schroetter syndrome: A contemporary review of the controversies in management.
Cai TY, Rajendran S, Saha P, Dubenec S
Phlebology 2020 Aug;35(7):461-471. Epub 2020 Feb 6 doi: 10.1177/0268355519898920. PMID: 32028850
Intravascular Ultrasound in Venous Thoracic Outlet Syndrome.
Kim TI, Sarac TP, Orion KC
Ann Vasc Surg 2019 Jan;54:118-122. Epub 2018 Sep 11 doi: 10.1016/j.avsg.2018.08.077. PMID: 30217714

Diagnosis

Venous thoracic outlet syndrome and Paget-Schroetter syndrome.
Modi BP, Chewning R, Kumar R
Semin Pediatr Surg 2021 Dec;30(6):151125. Epub 2021 Oct 30 doi: 10.1016/j.sempedsurg.2021.151125. PMID: 34930589
A review of upper extremity deep vein thrombosis.
Khan O, Marmaro A, Cohen DA
Postgrad Med 2021 Aug;133(sup1):3-10. Epub 2021 Mar 8 doi: 10.1080/00325481.2021.1892390. PMID: 33618595
Evaluation and Management of Venous Thoracic Outlet Syndrome.
Cook JR, Thompson RW
Thorac Surg Clin 2021 Feb;31(1):27-44. doi: 10.1016/j.thorsurg.2020.08.012. PMID: 33220769
Vascular Thoracic Outlet Syndrome.
Hussain MA, Aljabri B, Al-Omran M
Semin Thorac Cardiovasc Surg 2016 Spring;28(1):151-7. Epub 2015 Oct 28 doi: 10.1053/j.semtcvs.2015.10.008. PMID: 27568153
Venous thoracic outlet syndrome.
Moore R, Wei Lum Y
Vasc Med 2015 Apr;20(2):182-9. doi: 10.1177/1358863X14568704. PMID: 25832605

Therapy

Hybrid Paraclavicular Decompression for Venous Thoracic Outlet Syndrome with Primary Endovascular Reconstruction.
Miciura AL, Napier JA, Aziz A
Ann Vasc Surg 2023 Oct;96:335-346. Epub 2023 Apr 10 doi: 10.1016/j.avsg.2023.03.016. PMID: 37040840
Optimal management of upper extremity deep vein thrombosis: Is venous thoracic outlet syndrome underrecognized?
Illig KA, Gober L
J Vasc Surg Venous Lymphat Disord 2022 Mar;10(2):514-526. Epub 2021 Aug 2 doi: 10.1016/j.jvsv.2021.07.011. PMID: 34352421
Robot-assisted transthoracic first rib resection for venous thoracic outlet syndrome.
Hoexum F, Jongkind V, Coveliers HM, Yeung KK, Wisselink W
Vascular 2022 Apr;30(2):217-224. Epub 2021 Apr 9 doi: 10.1177/1708538121997332. PMID: 33832359
Paget-Schroetter syndrome: A contemporary review of the controversies in management.
Cai TY, Rajendran S, Saha P, Dubenec S
Phlebology 2020 Aug;35(7):461-471. Epub 2020 Feb 6 doi: 10.1177/0268355519898920. PMID: 32028850
The Paget-Schroetter syndrome.
Feugier P, Chevalier JM
Acta Chir Belg 2005 May-Jun;105(3):256-64. doi: 10.1080/00015458.2005.11679713. PMID: 16018517

Prognosis

Optimal management of upper extremity deep vein thrombosis: Is venous thoracic outlet syndrome underrecognized?
Illig KA, Gober L
J Vasc Surg Venous Lymphat Disord 2022 Mar;10(2):514-526. Epub 2021 Aug 2 doi: 10.1016/j.jvsv.2021.07.011. PMID: 34352421
How Common Is Thoracic Outlet Syndrome?
Illig KA, Rodriguez-Zoppi E
Thorac Surg Clin 2021 Feb;31(1):11-17. doi: 10.1016/j.thorsurg.2020.09.001. PMID: 33220767
Intravascular Ultrasound in Venous Thoracic Outlet Syndrome.
Kim TI, Sarac TP, Orion KC
Ann Vasc Surg 2019 Jan;54:118-122. Epub 2018 Sep 11 doi: 10.1016/j.avsg.2018.08.077. PMID: 30217714
Venous thoracic outlet syndrome.
Moore R, Wei Lum Y
Vasc Med 2015 Apr;20(2):182-9. doi: 10.1177/1358863X14568704. PMID: 25832605
The Paget-Schroetter syndrome.
Feugier P, Chevalier JM
Acta Chir Belg 2005 May-Jun;105(3):256-64. doi: 10.1080/00015458.2005.11679713. PMID: 16018517

Clinical prediction guides

Robot-assisted transthoracic first rib resection for venous thoracic outlet syndrome.
Hoexum F, Jongkind V, Coveliers HM, Yeung KK, Wisselink W
Vascular 2022 Apr;30(2):217-224. Epub 2021 Apr 9 doi: 10.1177/1708538121997332. PMID: 33832359
A review of upper extremity deep vein thrombosis.
Khan O, Marmaro A, Cohen DA
Postgrad Med 2021 Aug;133(sup1):3-10. Epub 2021 Mar 8 doi: 10.1080/00325481.2021.1892390. PMID: 33618595
Intravascular Ultrasound in Venous Thoracic Outlet Syndrome.
Kim TI, Sarac TP, Orion KC
Ann Vasc Surg 2019 Jan;54:118-122. Epub 2018 Sep 11 doi: 10.1016/j.avsg.2018.08.077. PMID: 30217714
Vascular Thoracic Outlet Syndrome.
Hussain MA, Aljabri B, Al-Omran M
Semin Thorac Cardiovasc Surg 2016 Spring;28(1):151-7. Epub 2015 Oct 28 doi: 10.1053/j.semtcvs.2015.10.008. PMID: 27568153
Venous thoracic outlet syndrome.
Moore R, Wei Lum Y
Vasc Med 2015 Apr;20(2):182-9. doi: 10.1177/1358863X14568704. PMID: 25832605

Recent systematic reviews

Management of Paget-Schroetter Syndrome: a Systematic Review and Meta-Analysis.
Hoexum F, Hoebink M, Coveliers HME, Wisselink W, Jongkind V, Yeung KK
Eur J Vasc Endovasc Surg 2023 Dec;66(6):866-875. Epub 2023 Sep 6 doi: 10.1016/j.ejvs.2023.08.065. PMID: 37678659

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