Assessment and treatment of recurrent venous thoracic outlet syndrome

Patients that have undergone treatment for venous TOS generally have excellent clinical outcomes, but a proportion of individuals may present with persistent, progressive, or recurrent upper extremity symptoms. The purpose of this chapter is to outline the spectrum of conditions that should be considered in evaluation of such patients and a systematic approach to classify and address these problems. It can be expected that with comprehensive evaluation and appropriate treatment, the majority of patients with persistent or recurrent venous TOS can experience decreased symptoms and restoration of normal upper extremity function. Evaluation of the deficiencies found during reoperations for venous TOS is informative with regard to the optimal approaches to be taken during primary operation for this condition.