The 10-year course of a complex recurrent venous thoracic outlet syndrome

Venous thoracic outlet syndrome classically presents with upper extremity venous thrombosis (Padget-Schroetter syndrome). The established treatment pathway includes thrombolysis with early surgical decompression of the thoracic outlet. This case is a 20-year-old woman initially treated erroneously with thrombolysis and subclavian vein stenting, without surgical decompression. Over the next decade, she experienced multiple recurrent complications, requiring several interventions. Despite multiple attempts to overcome the original procedure, her symptoms have reoccurred owing to restenosis and increasingly complex anatomy. This case highlights the importance of early recognition and definitive surgical intervention by trained vascular surgeons to optimize long-term outcomes in venous thoracic outlet syndrome.