Claviculectomy for subclavian venous repair: Long-term functional results

Objectives: The purpose of this study was to determine the long-term functi onal results after medial claviculectomy and venous patch angioplasty or by pass grafting using internal jugular vein. after incomplete thrombolysis of effort thrombosis of the subclavian vein. Methods: The records of 11 patients with effort thrombosis who were treated over the past 9 years were reviewed. Patients have been followed up betwee n 3 and 9 years at 6-month intervals with duplex imaging and contrast venog raphy when indicated and have had an orthopedic evaluation of their shoulde r function. Results: All reconstructed veins are patent, and only one patient complains of any arm swelling after prolonged usage. This patient is one of three wi th postphlebitic changes at the site of repair and has similar findings in her basilic vein. All patients have returned to their prethrombosis vocatio n without limitation. Pour of the 11 patients have jobs requiring heavy phy sical labor. No patient describes any limitations of shoulder function, bur one man who works as a diesel mechanic complains of shoulder aching with o veruse with repetitive pulling. Three patients describe upper extremity par esthesias when lying on the operated side. Two patients (one man and one wo man) are bothered by the large scar and indentation at the site of the inci sion. Every patient considers the overall result completely successful from a functional standpoint. Conclusions: Early subclavian venous repair performed through a medial clav iculectomy is a durable operation with excellent long-term functional resul ts. Half of the patients noted minor but significant symptoms, but all are uniformly able to return to normal function. (J Vasc Surg 2000;32:315-21.).