Primary subclavian-axillary vein thrombosis.

Primary thrombosis of the subclavian-axillary vein is a condition of uncertain origin resulting in proximal arm swelling, discomfort on use, and prominence of engorged collateral veins in the upper arm and chest. The literature is reviewed and the authors' own experience with 23 patients, evaluated from 1950 through 1966, is detailed. This disorder is a clinically distinct venous complication of the neurovascular compression syndrome of the upper extremity. Contrary to the findings recorded by others, spontaneous improvement following conservative management, while initially good, ceases after the first few months. After a mean follow-up period of 8 years, nine patients have major, and 12 have minor, residual symptoms when using the affected arm. Venous collateral patterns persist in all patients. Early venography and thrombectomy are proposed.