Case Reports
Vol. 12 (2023)
https://doi.org/10.4081/vl.2023.11673

An unusual case of venous thoracic outlet syndrome in relation to the anatomical position of the subclavian vein valves in a young athlete

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Received: 24 August 2023
Accepted: 22 September 2023
Published: 27 September 2023
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Venous Thoracic Outlet Syndrome, subclavian vein, subclavian valve, ultrasound M-mode, sport medicine

Authors

Anselmo Pagani
https://orcid.org/0000-0001-6359-0309
Department of Translational Medicine, University of Ferrara, Italy.
Giulia Baldazzi
giulia01.baldazzi@edu.unife.it
https://orcid.org/0000-0001-8589-5154
School of Vascular Surgery, University of Ferrara, Italy.
Roberta Ricci
https://orcid.org/0009-0001-3652-4370
School of Vascular Surgery, University of Ferrara, Italy.
Maddalena Bressan
https://orcid.org/0000-0002-3945-6369
School of Vascular Surgery, University of Ferrara, Italy.
Erica Menegatti
Department of Environmental Science and Prevention, University of Ferrara, Italy.

Venous Thoracic Outlet Syndrome (vTOS) consists of upper extremities oedema, sometimes with varicose dilation of the superficial veins of the arm in consequence of compression and/or thrombosis of the subclavian vein. More specific factors, such as muscle hypertrophy, have additionally been registered in athletes. The case focuses on a 20-year-old male student in medicine, with an intense training activity in body building. The subject has presented symptoms of upper limbs oedema he has also reported heaviness and paresthesia in the left arm and hand. Varicose dilation of a superficial vein close to the axillary fossa was visible at naked eye. Both Doppler ultrasound evaluation and Angio TC were negative for venous thrombosis and/or complete obstruction from external compression. These reports depict an uncommon clinical scenario, which correlate an intense upper body training activity with the presence of a second valve distally of the first valve into the subclavian vein.

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Crossref
Scopus
Google Scholar
Europe PMC
1. Anton N Sidawy, Bruce A Perler. Rutherford’s Vascular Surgery and Endovascular Therapy. Elsevier, Amsterdam, The Netherlands. 2018.
Watson LA, Pizzari T, Balster S. Thoracic outlet syndrome part 1: clinical manifestations, differentiation and treatment pathways. Man Ther. 2009;14:586-95. DOI: https://doi.org/10.1016/j.math.2009.08.007
Modi BP, Chewning R, Kumar R. Venous thoracic outlet syndrome and Paget-Schroetter syndrome. Semin Pediatr Surg. 2021;30:151125. DOI: https://doi.org/10.1016/j.sempedsurg.2021.151125
Li N, Dierks G, Vervaeke HE, et al. Thoracic Outlet Syndrome: A Narrative Review. J Clin Med. 2021;10:962. DOI: https://doi.org/10.3390/jcm10050962
Garraud T, Pomares G, Daley P, et al. Thoracic Outlet Syndrome in Sport: A Systematic Review. Front Physiol. 2022;13:838014 DOI: https://doi.org/10.3389/fphys.2022.838014
Farrar TA, Rankin G, Chatfield M. Venous thoracic outlet syndrome: approach to diagnosis and treatment with focus on affected athletes. Curr Sports Med Rep. 2014;13:81-5. DOI: https://doi.org/10.1249/JSR.0000000000000035
Zell L, Kindermann W, Marschall F, et al. Paget-Schroetter syndrome in sports activi-ties – case study and literature review. Angiology. 2001;52:337-42. DOI: https://doi.org/10.1177/000331970105200507
Keller RE, Croswell DP, Medina GIS, et al. Paget-Schroetter syndrome in athletes: a comprehensive and systematic review. J Shoulder Elbow Surg. 2020;29:2417-25. DOI: https://doi.org/10.1016/j.jse.2020.05.015
Hackett DA, Chow CM. The Valsalva maneuver: its effect on intra-abdominal pressure and safety issues during resistance exercise. J Strength Cond Res. 2013;27:2338-45. DOI: https://doi.org/10.1519/JSC.0b013e31827de07d
Mohammed NY, Di Domenico G, Sisini F, et al. Mechanical function of internal jugular vein valve: post analysis of M-mode imaging under cardiac monitoring. Veins and Lymphatics. 2019;8:8379.
Zamboni P, Tavoni V, Sisini F, et al. Venous compliance and clinical implications. Veins and Lymphatics. 2018;7:7367. DOI: https://doi.org/10.4081/vl.2018.7367
Mohammed NY, Di Domenico G, Sisini F, et al. Mechanical function of internal jugular vein valve: post analysis of M-mode imaging under cardiac monitoring. Veins and Lymphatics. 2019;8:8432. DOI: https://doi.org/10.4081/vl.2019.8432
Celepci H, Brenner E. Position of valves within the subclavian and axillary veins. J Vasc Surg. 2011;54:70S-6S. DOI: https://doi.org/10.1016/j.jvs.2011.06.083
Davidovic LB, Kostic DM, Jakovljevic NS, et al. Vascular thoracic outlet syndrome. World J Surg. 2003;27:545-50. DOI: https://doi.org/10.1007/s00268-003-6808-z
Rayan GM. Thoracic outlet syndrome. J Shoulder Elbow Surg. 1998;7:440-51. DOI: https://doi.org/10.1016/S1058-2746(98)90042-8

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An unusual case of venous thoracic outlet syndrome in relation to the anatomical position of the subclavian vein valves in a young athlete. (2023). Veins and Lymphatics, 12(1). https://doi.org/10.4081/vl.2023.11673
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