Phillies' Zack Wheeler diagnosed with venous thoracic outlet syndrome
Days after a successful blood clot removal procedure, the Philadelphia Phillies said right-handed pitcher Zack Wheeler has been diagnosed with venous thoracic outlet syndrome.
The Phillies said Wheeler is recommended to undergo thoracic outlet decompression surgery within the upcoming weeks. Initial details surrounding the surgery were limited.
However, the team said the road to recovery is typically 6-8 months.
Wheeler underwent a thrombolysis procedure on the morning of Aug. 18 to remove a blood clot near his right shoulder. The Phillies said Wheeler's procedure was performed by Dr. Paul DiMuzio at Thomas Jefferson University Hospital.
Thrombolysis, the procedure the Phillies' ace underwent, removes a blood clot with a catheter. Patients who undergo this type of procedure are generally put on blood thinners and are advised to rest for three months.
Dr. Michael Lieb, a vascular surgeon with Virtua Health who's not involved in Wheeler's case, spoke with CBS News Philadelphia about the treatment.
"This is usually a needle-based method," Lieb said. "Just like getting an IV or giving blood, the needle goes into the vein. There are different types of catheters to be used to pull the clot out.
"After a procedure like this, we still typically continue patients on blood thinners for several months afterward," Lieb added. "As far as his activity level, we do usually recommend that they rest and not do repetitive activities."
What is venous thoracic outlet syndrome?
The Cleveland Clinic defines venous thoracic outlet syndrome as a compressed subclavian vein. This vein carries blood from a person's arm to their heart. Those with VTOS may experience arm swelling, discoloration or heaviness – something Wheeler previously reported feeling earlier this month.
Cherie Erkmen, a thoracic surgeon at Temple University Hospital who is not involved in Wheeler's case, said the condition can be genetic or acquired.
"So when people have a repetitive motion like pitching, the neck muscles can become overdeveloped and pull that first rib up and then squeeze on either the nerve, artery or vein, or all three structures," Erkmen said. "When we talk about venous thoracic outlet syndrome, that's when it's pressed on the vein enough that it has caused a blood clot or some other problem."
Erkmen said recovery can take at least several weeks, but for top athletes, it can take longer.
"Part of the problem with thoracic outlet syndrome is that it's not well known, even though it's prevalent, especially among athletes and people with certain professions, that they go a long time without a diagnosis and they're struggling and they're seeing spine surgeons and neurologists," she said.
Erkmen said anyone experiencing numbness, tingling, swelling or discoloration that comes and goes, or a more serious issue like a blood clot, should talk to their physician about thoracic outlet syndrome.