Differential Diagnosis, Decision-Making, and Pathways of Care: Acute Thrombosis and Non-thrombotic Positional Compression

Abstract

Venous thoracic outlet syndrome (VTOS) may present with a variety of symptoms and at different stages of the disease process. While the common denominator of these varied presentations is subclavian vein compression at the thoracic outlet, management of each presentation has different elements and decision making. Thrombolysis, angioplasty, stenting, and surgical decompression may be appropriate for some presentations, but may not serve for others. This chapter discusses the management of acute subclavian vein thrombosis (Paget Schroetter syndrome) and non-thrombotic positional compression (McCleery’s syndrome). The focus of this chapter is on the evaluation and the care pathways which lead to best outcomes for these patients.