Axillary-subclavian venous thrombosis

From 1974 through 1984 six patients with axillary-subclavian venous thrombosis were studied and treated. This disorder represents 1% of the various types of venous thrombosis reported in the literature. Symptoms appeared following effort in four patients, while a cervical rib and a scar bridle after radical mastectomy were identified as the underlying cause in two patients. Ages ranged from 17 to 59 years, with a mean age of 33 and equal sex distribution. None of the six patients had blood clotting defects. The diagnosis was based on clinical evaluation and was confirmed by phlebography. There was edema and functional impairment of the arm in all cases. Pain and venous prominence was found in 83%, rubor of the extremity in 66%, local hyperthermia in 50%, and arterial compression in 33%. Five patients were treated with anticoagulants and bed rest. Surgery was performed in two patients with thoracic outlet syndrome. First rib resection with scalenotomy was performed in one case and cervical rib resection with scalenotomy in the other. After a mean follow-up of 13 months, the results were good in four and average in two patients.