{
  "abstract": "Background: Thrombotic venous thoracic outlet syndrome (T-vTOS), including Paget-Schrotter syndrome, is a rare form of upper extremity deep vein thrombosis that mainly affects young, active individuals. Its optimal management remains debated, and the medium-term outcomes have been poorly documented.\n\nMethods: This retrospective study included consecutive patients diagnosed with T-vTOS at the vascular medicine department of a university hospital between 2014 and 2024. Patients were stratified according to the presence of post-thrombotic syndrome (PTS) using the modified Villalta score at the last follow-up (<5 vs ≥5). Clinical characteristics, therapeutic strategies, and outcomes were systematically assessed through a standardized evaluation performed by the same physician. Univariable and multivariable logistic regression analyses, using Firth’s penalized-likelihood method to account for the limited number of events, were performed to identify the factors associated with PTS.\n\nResults: A total of 50 patients were included: 28 with a Villalta score of <5 and 22 with a Villalta score of ≥5 at the last follow-up. Patients with a Villalta score of <5 achieved higher rates of complete subclavian vein recanalization at follow-up (63% vs 32%; P = .045) and were less likely to have persistent subclavian vein occlusion (26% vs 59%; P = .023). Patients with a Villalta score of ≥5 more often required prolonged anticoagulation (73% vs 29%; P = .004) and more frequently underwent acute-phase endovascular treatment (36% vs 4%; P = .007). In the multivariable analysis, endovascular treatment alone without thoracic outlet surgery was associated with an increased risk of PTS (odds ratio, 10.6; 95% confidence interval, 1.15, 98.09) (P = .037), whereas no association was found between the risk of PTS and patients who had undergone both endovascular treatment and TOS surgery (odds ratio 1.3; 95% confidence interval, 0.26, 6.87) (P = .736).\n\nConclusions: This study highlights the central role of venous patency in the clinical course of T-vTOS, with persistent subclavian vein occlusion associated with an increased risk of PTS. The association observed between acute-phase endovascular treatment alone and the risk of PTS 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 PTS.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Internal and Vascular Medicine, Nantes Université, CHU Nantes, Nantes, France",
    "Department of Vascular Medicine, European Hospital Georges Pompidou, Paris, France",
    "Department of Radiology Medicine, Nantes Université, CHU Nantes, Nantes, France",
    "Department of Physical Medicine and Rehabilitation, Nantes Université, CHU Nantes, Nantes, France",
    "Department of Orthopaedics, Nantes Université, CHU Nantes, Nantes, France",
    "Department of Vascular Medicine, Brest Université, CHU, Brest, France",
    "Brest Université, Inserm, UMR 1304, GETBO, Brest, France",
    "Department of Vascular Surgery, Nantes Université, CHU Nantes, Nantes, France",
    "Nantes Université, CHU Nantes, CNRS UMR 6291, INSERM UMR 1087, l'institut du thorax Team III Vascular and Pulmonary Diseases, Nantes, France"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Samy Benhalima"
    },
    {
      "affs": [
        0
      ],
      "name": "Giovanni Gautier"
    },
    {
      "affs": [
        2
      ],
      "name": "Frédéric Douane"
    },
    {
      "affs": [
        3
      ],
      "name": "Alban Fouasson-Chailloux"
    },
    {
      "affs": [
        4
      ],
      "name": "Guillaume Gadbled"
    },
    {
      "affs": [
        5,
        6
      ],
      "name": "Benjamin Espinasse"
    },
    {
      "affs": [
        7,
        8
      ],
      "name": "Blandine Maurel"
    },
    {
      "affs": [
        0,
        8
      ],
      "name": "Marie Morard"
    },
    {
      "affs": [
        0,
        8
      ],
      "name": "Olivier Espitia"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6x10pmk9arm7n.bib",
  "cited_by": 0,
  "doi": "10.1016/j.jvsv.2026.102639",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13743419/",
  "id": "6x10pmk9arm7n",
  "issns": [
    "2213-333X",
    "2213-3348"
  ],
  "landing_url": "https://doi.org/10.1016/j.jvsv.2026.102639",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Venous thrombotic event"
    ],
    [
      "openalex",
      "2724|Venous Thromboembolism Diagnosis and Management"
    ]
  ],
  "openalex": "W7221155836",
  "pdf_url": "https://www.jvsvenous.org/article/S2213-333X(26)00199-X/pdf",
  "pmcid": "PMC13743419",
  "pmid": "42855073",
  "published": "2026-10-09",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/6x10pmk9arm7n.ris",
  "sources": [
    {
      "first_seen": "2026-11-10T12:24:10Z",
      "native_id": "PMC13743419",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.jvsv.2026.102639"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2746|Vascular anomalies and interventions",
      "subfield": "surgery"
    }
  ],
  "title": "Post-thrombotic syndrome after thrombotic venous thoracic outlet syndrome",
  "title_text": "Post-thrombotic syndrome after thrombotic venous thoracic outlet syndrome",
  "type": "peer-reviewed",
  "updated_at": "2026-11-10T12:24:10Z",
  "url": "https://research.draconitic.com/paper/6x10pmk9arm7n",
  "venue": "Journal of Vascular Surgery: Venous and Lymphatic Disorders",
  "versions": []
}