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Updated: Jun 27, 2025

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
Published on: September 13, 2020
The infraclavicular approach for venous thoracic outlet syndrome
Sarah A Loh1, Britt H Tonnessen1
1Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale School of Medicine, 330 Cedar Street, Boardman 204, New Haven CT 06519.
Abstract:
Venous thoracic outlet syndrome (vTOS) is an esoteric condition that presents in young, healthy adults. Treatment includes catheter-directed thrombolysis, followed by first-rib resection for decompression of the thoracic outlet. Various techniques for first-rib resection have been described with successful outcomes. The infraclavicular approach is well-suited to treat the most medial structures that are anatomically relevant for vTOS. A narrative review was conducted to specifically examine the literature on infraclavicular exposure for vTOS. The technique for this operation is described, as well as the advantages and disadvantages of this approach. The infraclavicular approach is a reasonable choice for definitive treatment of uncomplicated vTOS.
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