The Infraclavicular Approach for Venous Thoracic Outlet Syndrome

Venous thoracic outlet syndrome is an esoteric condition that presents in young healthy adults. Treatment includes catheter-directed thrombolysis followed by first rib resection for decompression of the thoracic outlet. Various techniques for first rib resection have been described with successful outcomes. The infraclavicular approach is well-suited to treat the most medial structures which are anatomically relevant for vTOS. A narrative review was conducted to specifically examine the literature on infraclavicular exposure for vTOS. We describe our technique for this operation as well as advantages and disadvantages of this approach. The infraclavicular approach is a reasonable choice for definitive treatment of uncomplicated vTOS.