VTOS in the competitive athlete

Axillary-subclavian vein (ASCV) effort thrombosis (Paget-Schroetter syndrome) is the acute manifestation of venous thoracic outlet syndrome (VTOS). While relatively uncommon, this condition is probably the most frequently encountered vascular disorder in the young, healthy, competitive athlete. Understanding VTOS is particularly important for vascular and thoracic surgeons caring for athletes, as well as orthopedic surgeons, emergency room physicians, and sports medicine specialists, since delayed diagnosis and/or incomplete treatment can prevent further participation in sports and recreational activities. Although the treatment options to be considered for VTOS are similar for all patients, competitive athletes often present special circumstances that need to be taken into account in the decision-making process. With early recognition, proper initial treatment, and definitive surgical care, most competitive athletes affected by VTOS can return to previous levels of performance within several months of diagnosis.