Subclavian Vein Thrombosis in a Patient With Venous Thoracic Outlet Syndrome and Previous Preventive First Rib Resection

Deep vein thrombosis (DVT) associated with venous thoracic outlet syndrome (vTOS) after rib resection is rare. In younger, physically active people, repetitive upper extremity activity can lead to effort thrombosis (Paget-Schroetter syndrome), as the subclavian vein is chronically injured and becomes fibrotic. Without restored patency, venous collaterals form as a compensatory mechanism to overcome chronic occlusion. We report a successful mini-invasive endovascular thrombectomy for right subclavian vein thrombosis in a 33-year-old female patient with bilateral first rib resection performed at another hospital 10 years prior, which was performed as a secondary thrombosis prevention on the left side and as primary thrombosis prevention on the right, non-acutely thrombosed side. We discuss key therapeutic aspects, including anticoagulation duration, need for reintervention, and indication for stent placement after rib resection.