Subclavius and Anterior Scalene Muscle Compression as a Cause of Intermittent Obstruction of the Subclavian Vein

McCleery, Robert S.; Kesterson, John E.; Kirtley, James A.; Love, Ross B.

doi:10.1097/00000658-195105000-00002

Cited by 88 publications

(32 citation statements)

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“…Because of the obliquity of the muscle upward, backward and inward and the fact that the transverse, slightly concave, course of the vein is always lower than the course of the artery, of which it somewhat represents the chord of the arc, the subclavian vein in this segment is always comfortable behind the clavicle. Like Mercier [14], we have never in the course of our dissections observed the zone of potential pressure described by Mac Leery [12] between the posterior border of the clavicle and the anterior aspect of the scalenus anterior.…”

Section: Dynamic Concept Of the Thoraco-brachial Outletsupporting

confidence: 56%

Morphologic and functional anatomy of the subclavian veins

et al. 1986

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50 jugulo-subclavian venous junctions were removed to study the endovenous structures of the subclavian vein and of this junction. The diameter of the subclavian vein is always less than that of the internal jugular vein. Valvules were constantly found, whereas endovenous structures such as those found in the ilio-caval junctions were very rare. In view of these findings, these structures may be regarded as of embryologic origin.

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Section: Dynamic Concept Of the Thoraco-brachial Outletsupporting

confidence: 56%

Morphologic and functional anatomy of the subclavian veins

et al. 1986

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“…1 The syndrome is a rare presentation, accounting for 5% of all cases of thoracic outlet syndrome (TOS), a compression phenomena of the neurovascular structure of the shoulder. 2,3 It is mostly seen in active and athletic individuals, and results from repetitive upper extremity motion. Historically, treatment for this syndrome consisted of arm elevation and routine anticoagulation.…”

mentioning

confidence: 99%

Preoperative thrombolysis and venoplasty affords no benefit in patency following first rib resection and scalenectomy for subacute and chronic subclavian vein thrombosis

Guzzo

Chang

Demos

et al. 2010

Journal of Vascular Surgery

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Preoperative endovascular intervention offered no benefit over simple anticoagulation prior to FRRS, since the use of thrombolysis prior to FRRS, regardless of need for postoperative venoplasty, had little impact on overall rates of patency. The optimal treatment algorithm may merely be routine anticoagulation for all effort thrombosis patients prior to FRRS followed by venography with venoplasty if needed. The role of thrombolysis for Paget-Schroetter syndrome should be further investigated in randomized trials.

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“…The rationale behind this nomenclature lies in the underlying pathogenesis: a reduced costoclavicular space due to anatomical abnormalities at the thoracic outlet causes the subclavian vein to be compressed; this results in endothelial distortion of the subclavian vein. Each time ‘effort’ is exerted on the affected side, it causes a resultant cycle of further endothelial trauma, leading to hyperplasia and fibrosis which subsequently causes venous stasis, thrombus formation and further crowding in the costoclavicular space 7 8. When the subclavian vein is totally occluded, the forming thrombus can extend into the axillary vein.…”

Section: Discussionmentioning

confidence: 99%