Abstract
Venous thoracic outlet syndrome (VTOS) is characterised by compression of the subclavian vein (SCV) as it passes through the thoracic outlet bordered by the clavicle, first rib, and scalene muscles. Owing to repetitive venous compression during arm movement, fibrosis and, eventually, thrombosis occurs, which may lead to the post-thrombotic syndrome (PTS). To decrease the incidence of PTS, current treatment strategies focus on recanalisation and long term SCV patency, and include oral anticoagulation therapy (OAC), thoracic outlet decompression (TOD), surgical thrombectomy, and endovascular interventions (thrombolysis, venoplasty, thrombus aspiration, and stenting).
Highlights
Venous thoracic outlet syndrome (VTOS) is characterised by compression of the subclavian vein (SCV) as it passes through the thoracic outlet bordered by the clavicle, first rib, and scalene muscles
In various studies on iliofemoral venous disease and one VTOS series, intravascular ultrasound (IVUS) was more sensitive than venography in determining the degree and length of the stenotic lesion and detecting intraluminal disease such as thrombus, septations, and frozen valves.3e5
IVUS may be of added value in VTOS, considering the risk of intraluminal fibrosis and septations
Summary
Venous thoracic outlet syndrome (VTOS) is characterised by compression of the subclavian vein (SCV) as it passes through the thoracic outlet bordered by the clavicle, first rib, and scalene muscles. Owing to the distinction of the intima from surrounding tissue, intraluminal problems may be identified.2 Another possible advantage of IVUS over venography is the creation of cross sectional instead of unidirectional images. IVUS is commonly used in coronary interventions to visualise plaques, optimise stent implantation, and improve long term outcome. In various studies on iliofemoral venous disease and one VTOS series, IVUS was more sensitive than venography in determining the degree and length of the stenotic lesion and detecting intraluminal disease such as thrombus, septations, and frozen valves.3e5
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