title: McCleery syndrome: etiology and outcome.
abstract: OBJECTIVE
  Patients presenting with swelling of the upper extremity without thrombosis have McCleery syndrome or intermittent compression of the subclavian vein. The purpose of this study was to determine outcomes in these patients who underwent first rib resection and scalenectomy (FRRS).
  
  
  METHODS
  Using a prospectively maintained database from 2003 to 2011, patients were retrospectively reviewed for presentation, diagnosis, treatment, and clinical outcomes.
  
  
  RESULTS
  Of the patients presenting with venous thoracic outlet syndrome, 19 (11%; 13 F/6 M; mean age 26 [10-44]) presented with intermittent arm swelling, of which 3 were identified as having chronic thrombus. A total of 20 FRRS operations were performed.
  
  
  CONCLUSIONS
  First rib resection and scalenectomy is effective in relieving symptoms in patients with McCleery syndrome. These patients do not generally need a postoperative venogram unless they experience continuing symptoms. In patients with chronic thrombus, routine postoperative venography at 2 weeks is indicated. Patients can present with intermittent compression if an acute episode of deep vein thrombosis is not aggressively treated.
authors: 1Vascular and Endovascular Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors: Kendall
authors: K
authors: Likes
authors: Danielle H
authors: DH
authors: Rochlin
authors: Diana
authors: D
authors: Call
authors: Julie A
authors: JA
authors: Freischlag
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D019299:Decompression, Surgical / Q000379:methods; D004487:Edema / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D010690:Phlebography; D012189:Retrospective Studies; D012272:Ribs / Q000601:surgery; D012307:Risk Factors; D013350:Subclavian Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D013901:Thoracic Outlet Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014654:Vascular Patency; D055815:Young Adult
keywords: Doppler; chronic disease; decompression; duplex; retrospective studies; ribs/surgery; subclavian vein/ultrasonography; surgical; treatment outcome; ultrasonography; vascular patency