False-Negative Upper Extremity Ultrasound In The Initial Evaluation Of Patients With Suspected Subclavian Vein Thrombosis Due To Thoracic Outlet Syndrome (Paget-Schroetter Syndrome)

Duplex ultrasound has significant limitations in the initial evaluation of patients with suspected SCV thrombosis, with false-negative results in 21% of patients with proven VTOS. This is rarely acknowledged in ultrasound reports, but false-negative ultrasound studies have the potential to delay definitive imaging, thrombolysis, and further treatment for VTOS. Initial false-negative ultrasound results are associated with progressive thrombus extension and a more frequent need for SCV bypass reconstruction at the time of surgical treatment.