Rib-sparing subclavian vein decompression in venous thoracic outlet syndrome.

Area of Science:

• Vascular Surgery
• Thoracic Surgery
• Medical Devices

Background:

• Venous thoracic outlet syndrome (VTOS) is often treated with first rib resection, an invasive procedure with potential complications.
• Non-bony decompression offers a less invasive alternative for managing VTOS.

Purpose of the Study:

• To evaluate the long-term outcomes of non-bony decompression via subclavius muscle and tendon resection for VTOS.
• To provide a detailed procedural description of this alternative surgical technique.

Main Methods:

• A single-center, cross-sectional study analyzed patients who underwent rib-sparing decompression for VTOS.
• Clinical, radiological examinations, and patient-reported outcome measures (DASH, VEINES-QOL/SYM) were used.

Main Results:

• Ten patients (7 Paget-Schroetter, 3 McCleery syndrome) showed symptom resolution at a mean follow-up of 45.4 months.
• All patients had patent vasculature, no post-thrombotic syndrome (Villalta score <4), minimal disability (DASH 3.8), and high quality of life (VEINES-QOL 92.6, VEINES-SYM 92.7).

Conclusions:

• Non-bony decompression by subclavius muscle and tendon resection is a safe and effective treatment for VTOS.
• This method is less invasive than first rib resection, offering definitive treatment with favorable long-term results.