Post thrombotic syndrome after thrombotic venous thoracic outlet syndrome

Background Thrombotic venous thoracic outlet syndrome (T-vTOS) including Paget-Schrotter syndrom is a rare form of upper extremity deep vein thrombosis (UEDVT) that mainly affects young, active individuals. Its optimal management remains debated and medium-term outcomes are poorly documented.Methods Consecutive patients from the vascular medicine department of a university hospital with T-vTOS between 2014 and 2024 were included in a retrospective study. Patients were stratified according to the presence of post-thrombotic syndrome with the modified Villalta score at last follow-up (Results Fifty patients were included: 28 with a Villalta score Conclusion This study highlights the central role of venous patency in the clinical course of T-vTOS, with persistent subclavian vein occlusion associated with post-thrombotic syndrome. The association observed between acute-phase endovascular treatment alone and post-thrombotic syndrome does not support a clear benefit of this strategy. However, endovascular therapy in conjunction with surgical decompression of the thoracic outlet may reduce the risk of post-thrombotic syndrome.