VENOUS ENTRAPMENT SYNDROMES

VENOUS ENTRAPMENT SYNDROMES

The axillary vein and the popliteal vein are the two veins that are most commonly compressed. The former is compressed at the thoracic outlet between the �rst rib and the clavicle, where it usually presents as an axillary vein thrombosis (see Axillary vein thrombosis ) ( Figure 62.37a ). The latter is compressed by an abnormal insertion of the gastrocnemius muscles. Entrapment may cause discomfort and swelling of the limb during exercise before thrombosis develops. Treatment is by surgical decompression, excising the �rst rib or dividing the abnormal musculature of the gastrocnemius insertion.