Venous thoracic outlet syndrome (vTOS) is a unilateral (rarely bilateral) form of thoracic outlet syndrome (approximately 4%), due to an extrinsic compression of the subclavian vein which can be divided into thrombotic and non thrombotic clinical entities.
In this study, the author underlines the usefulness of Echo-Color-Doppler diagnostic to evidence an intermittent subclavian vein compression, without intraluminal thrombus, in patients who had undergone breast surgery, with axillary lymphadenectomy, who refer homolateral positional  heaviness onset, fatigue, turgidity of the dorsal veins of the hand and cyanosis during the elevation of the homolateral arm (venous claudicatio) while performing work activities that can be resolved by resting the limb.
In this study, the subclavian venous obstacle discharge was due to impaired posture and predisposing morphotype (weak muscular support of the shoulder girdle): it was completely resolved through personalised physical therapy programme, in order to take pressure off the vein in the thoracic outlet, with complete disappearance of symptoms and consequent improvement in the performance of work activities and quality of life.
Furthermore, the resolution of non thrombotic venous thoracic outlet, through physical therapy, avoids the possibility of deep vein thrombosis onset due to the intermittent narrowing of the subclavian vein.