Percutaneous transluminal angioplasty and transaxillary first rib resection. A multidisciplinary approach to the thoracic outlet syndrome.

A 33-year-old man with the thoracic outlet syndrome complicated by recurrent upper extremity deep venous thrombosis underwent venographic and dynamic venous pressure studies that suggested both extrinsic and intrinsic venous obstruction. The patient was treated with transaxillary first rib resection and percutaneous transluminal angioplasty of the involved subclavian vein stenosis and is symptom-free at 16 months follow-up. To our knowledge this is the first case in which such a multidisciplinary approach to the thoracic outlet syndrome has been performed.