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First rib resection due to DVT

Posted , 8 users are following.

Simurgh
Simurgh

Hello to you all, 

 

I need advice from good people here J 

 

Here is my story.

I am a health 27 male.

 

Last year, after training for a half-marathon I experienced some pain in my shoulder area. At the time I ignored the symptoms and continued with the training. 

 

This continued till one night my arm went purple and very swollen. I went to A&E and was diagnosed with subclavian DVT. They put me on Warfarin and sent me home. The next few months I continued with taking Warfarin and my arm improved pretty much to normal appearance within 2-3 months. After they checked all the blood work I did (and all was ok), they sent me to do MRI scan with the dye injected. 

 

After that I saw a vascular team once and they said I have significant narrowing of the subclavian veins only when I raised my hands. Both arteries look fine. This is the case on both sides. After that they offered me a surgery, but didn't really push for it. They said it is surgery (first rib resection on both sides) or I would need to down my training and to be careful with any future intense physical activity + to keep taking warfarin.

 

I must say I don't have any pain or any other significant symptoms. Sometimes when I run (I still do), I feel some pain in my shoulder area but it's not too bad. (3 or 4 out of 10).

 

Reading all the experiences on this forum, I found that most people do the surgery because of the pain or other symptoms. I didn't have any symptoms apart from DVT and I have very occasional pain in shoulder area.

 

What are you thoughts on this? I am mostly afraid that I would feel much worse after the surgery than now. But on the other hand I don't want to risk getting another clot or bleeding due to taking warfarin. 

 

Any good surgeons dealing with vascular TOS in UK?

0 likes, 22 replies

22 Replies

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  • Ski2016
    Ski2016 Simurgh

    Posted

    Simurgh, 

    I was a healthy 27 year old, active female when diagnosed with VTOS in 2015 (not sure the exact differences between VTOS and DVT but similar symptoms you mention). 

    The narrowing of my subclavian vein was at approx. a 10% flow, only on one side and I was diagnosed before anyone swelling occured due to an x-ray for random pain in my lower abdomoen (unrelated). To avoid eneviatable clotting so close to the heart my surgeon essentially said it was not really a choice, but necessary. 

    So for what ever it is worth, I would ask your surgeon or specialist at what point the narrowing of the vein becomes dangerous. My surgeon said when its pinched more than 50-60% that is when he suggests his patients get the first rib resection. When its narrowed to 15% or lower, he said it is urgent. You are lucky your arm healed and went back to normal. My surgeon said its often life-changing once you clot and far more complications can occur. However many complications can occur from surgery as well.

    If its not effecting your day to day life I would suggest holding off, but if its very narrow my opinion would be to get surgery while you are active and healthy. The older you get, usually  the longer healing takes after invasive surgery. In my case, my surgeon wanted to see me get surgery now so I would not run into thrombosis problems or clotting when/ if I planned to get pregant in a few years.

    Best of luck!

    Anna 

     

    • victoria93724
      victoria93724 Ski2016

      Posted

      Hi there,

      I suffered a DVT in April 2015. I am a 30 yr old healthy female who has always been active. My shoulder/neck pain started to worsen when I started getting into triathlons, and eventually ended up with a subclavian DVT while travelling. I have been on Xarelto since ( they took me off after 4 mths but I ended up with small clots while travelling again so they put me back on it ). Basically the discussion of surgery has been ongoing and I decided to have it done on Jan 11, 2017. 

      The pain I experience is bearable, but it does affect my daily life as I want to be very active and feel that it holds me back. Also, I am an optometrist and am doing alot of overhead motion through the day. I have only been practicing 4 years, and want to have a long career, so the doctors felt this was the best option.  I have lots of collaterals present and the blood flow is okay, but my arm basically remains swollen most of the time, and is always darker in colour compared to my other arm. I am very nervous to have the surgery, and understand I will likely not get full relief, but my hope it to be comfortable and active on a day to day basis. The surgeon feels I will be able to get off the blood thinner 6 weeks post surgery, but my internist feels differently, and I am scared to ever to ever got off of it and end up with another DVT. Were you able to get off thinners or did you stay on them post surgery? Any advice before more surgery would be great! 

      Thank you,

      Victoria

    • leigh57835
      leigh57835 victoria93724

      Posted

      I had my first rib resection in 1993. I was one if the first to have it done. I haven't had any problems since then.

  • leigh57835
    leigh57835 Simurgh

    Posted

    I had the first rib resection 27 years ago. I was one of the first people to have this procedure. I haven't had any problems since then!

  • leigh57835
    leigh57835 Simurgh

    Posted

    had the surgery 27 years ago . One of the first in country to have it. Haven't had any problems.

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