PMC7287343_01
Arm at 90  abduction at presentation. A compressed axillary vein in abduction, situated at the lateral border of the pectoralis minor muscle with prominent collateral veins is seen in the right arm and thoracic outlet.
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VTOS, venography was performed at rest, abduction, adduction, and military attitude. Venography showed a compressed axillary vein in abduction, situated at the lateral border of the pectoralis minor muscle with prominent collateral veins (Fig. 1).
Situation directly after first rib resection in the operating room. The patency is restored at the level of the axillosubclavian vein. However, persistent collateral veins and suboptimal blood flow were seen in abduction at the level of the costoclavicular junction.
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In the same session, venography was performed in the hybrid operating room to assess vein patency (Fig. 2).
Situation after first rib resection and PTA in 90  abduction. The axillosubclavian vein was fully patent without collateral veins.
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After PTA, the axillosubclavian vein was then fully patent without collateral veins (Fig. 3).
Follow up venogram after 12 months in 100  abduction, which shows a patent axillosubclavian vein with no collaterals.
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Follow up venography at three and 12 months showed a patent axillosubclavian vein with no collaterals (Fig. 4).