Thankfully, Heil et al. have now addressed in their work a clinical picture that frequently occurs in everyday clinical practice yet has a therapy that raises many questions, which are often insufficiently answered by reliable data (1). In addition, an important causal complex should be pointed out here.
Especially for younger patients, the compression syndromes of the upper thoracic outlet (the so-called thoracic outlet syndrome [TOS]) may give rise not only to lesions of the arterial tract but also to compression and damage of the subclavian or axillary vein. This may have a constitutional basis (compression of the anterior scalene muscle, presence of a cervical rib) or be due to excessive physical stress (bodybuilding, effort-induced thrombosis) in terms of a Paget–von Schrötter disease. In addition to anticoagulation and potentially recanalization, elimination of the anatomical obstruction (for example, the cervical rib) also plays a role in therapy (2, 3).
Footnotes
Conflict of interest statement
The author declares that no conflict of interest exists.
References
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