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Consent was obtained or waived by all participants in this study. Published online Apr Author information Article notes Copyright and License information Disclaimer. Corresponding author. Amitoj Singh moc. Accepted Apr This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract Paget-Schroetter syndrome, also known as venous thoracic outlet syndrome, is primarily an effort-induced thrombosis of the subclavian and axillary veins. Keywords: pvd: peripheral vascular disease, paget-schroetter syndrome, deep vein thrombosis dvt , mechanical thrombectomy mt , catheter-directed thrombolysis. Introduction Thoracic outlet syndrome TOS refers to a group of disorders that presents with features of neurovascular bundle compression as it traverses through the thoracic outlet.
Case presentation A year-old female on oral contraceptives OCPs presented to the emergency department with three days of right upper extremity swelling and discomfort with movement.
Figure 1. Open in a separate window. Duplex ultrasound reveals non-compressibility and lack of flow in the right axillary vein consistent with occlusive deep vein thrombosis. Figure 2. Delayed phase on CT angiography demonstrating a large filling defect in the mid and distal right subclavian vein.
The right internal jugular and superior vena cava were patents. Figure 3. Axillary venography demonstrating complete occlusion of the right subclavian vein. Figure 4. Post catheter directed thrombolysis showing recanalization of the subclavian and axillary veins but with residual thrombus in the mid subclavian vein at the site of compression. Figure 5. Digital subtraction venography post mechanical thrombectomy with significant improvement in the thrombus burden.
Discussion A myriad of approaches have been described in the literature for treatment of acute DVT. Conclusions Paget-Schroetter syndrome is an effort induced thrombosis of the subclavian and axillary veins. Human Ethics Consent was obtained or waived by all participants in this study. References 1. National Organization for Rare Disorders: Thoracic outlet syndrome. Enhancing Healthcare Team Outcomes The diagnosis and management of PSS are best accomplished with an interprofessional team that consists of a primary care provider, sports medicine clinician, vascular surgeon, and radiologist.
Review Questions Access free multiple choice questions on this topic. Comment on this article. Figure Patient with bilateral first rib resection. Figure cervical rib on chest x-ray. Image courtesy S Bhimji MD.
Figure The right subclavian artery and surrounding structures. Figure Cervical rib. References 1. Turk Kardiyol Dern Ars. Kardiol Pol. On the centenary of the death of Sir James Paget and on the 50th anniversary of the naming of the syndrome]. Dtsch Med Wochenschr. Variability in the management of line-related upper extremity deep vein thrombosis. Effort Thrombosis Provoked by Saxophone Performance. J Emerg Med.
Post-thrombotic syndrome and recurrent thromboembolism in patients with upper extremity deep vein thrombosis: A systematic review and meta-analysis. Thromb Res. J Pediatr. J Tehran Heart Cent. American Society of Hematology guidelines for management of venous thromboembolism: diagnosis of venous thromboembolism. Blood Adv. Surgical and endovascular central venous reconstruction combined with thoracic outlet decompression in highly symptomatic patients.
Paget-Schroetter syndrome. BMJ Case Rep. Endovascular Therapy for Central Venous Thrombosis. Methodist Debakey Cardiovasc J. Pharmacomechanical Thrombectomy in Paget-Schroetter Syndrome. Cardiovasc Intervent Radiol. Paget-Schroetter syndrome as a result of 1st rib stress fracture due to gym activity presenting with Urschel's sign - A case report and review of literature. Int J Surg Case Rep. Paget Schroetter Syndrome.
In: StatPearls [Internet]. In this Page. Related information. Similar articles in PubMed. Venous thoracic outlet syndrome and Paget-Schroetter syndrome. Semin Pediatr Surg. Our analysis results are available to researchers, health care professionals, patients testimonials , and software developers open API.
All information is observation-only. Our phase IV clinical studies alone cannot establish cause-effect relationship. Different individuals may respond to medication in different ways. Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect.
The use of the eHealthMe site and its content is at your own risk. In diagnostic investigation, imaging exam is essential. Early diagnosis of the syndrome allows the early start of treatment, leading to better results and prognosis.
Conclusion: Therefore, this study has the goal of making the diagnosis more effective and improves the clinical-surgical management, from the increase in the level of medical professionals' suspicion regarding the disease.
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