Hi Everyone, I am new to this board….
In may 2013, I was diagnosed with DVT in my left arm - blood tests, CT scans, etc revealed no true cause of the blood clot. I was put on blood thinners for 3 months then switched to baby aspirin indefinitely as a precaution. Two weeks ago, a random blood vessel burst in my finger on that same arm,which prompted me to go see my doctor. He then referred me to a vascular surgeon here in st louis (Dr Thompson) to see if maybe there was something anatomical in my veins/arm that had caused the blood clot.

Dr Thompson ordered an MRA, and I met with him this week to go over the results. He said I have venous TOS and have two options - blood thinners for the rest of my life, which reduce the risk, but not 100% of having another clot, or having surgery to remove my first rib (his recommendation).

The radiologist findings from the MRA are as follows:
-With the arms down, there is an extrinsic impression from the left 1st rib on the inferior aspect of the left subclavian vein in the left costoclavicular space that mildly narrows but does not cause occlusion. With the arms raised, there is severe symmetric bilateral stenosis of the subclavian veins at the level of the costoclavicular spaces, resulting in subtotal occlusion.

This came as a complete shock to me - I am not sure what to make of it. I don't have any pain or symptoms in my arm since the blood clot nearly a year ago (other than the blood vessel burst, which the Dr. said was unrelated to my TOS). Because of this, I am hesitant to go forward with the surgery…how do I know I really have TOS, or is the doctor just being overly aggressive (is mild narrowing normal?)? Does anyone have thoughts, or possibly a similar story? I will definitely send my MRA scans to another doctor for a second opinion - any recommendations in the St Louis area, or around Ann Arbor/Metro Detroit?

Thanks so much!!