A comprehensive review of Paget-Schroetter syndrome

Illig, Karl A.; Doyle, Adam J.

doi:10.1016/j.jvs.2009.12.022

Cited by 350 publications

(373 citation statements)

References 64 publications

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“…Effort-related UEDVT often affected individuals who were young and healthy, with a male-to-female ratio of approximately 2:1. 11 The incidence is higher in males and similar findings were also found in this study, and males were younger than females. Pain and swelling are commonly present in patients with UEDVT as shown in a study by Mustafa et al 4 Similarly, swelling was the most prevalent sign in our study, which was seen in 96.6% of patients, and represented the most common sign of UEDVT.…”

Section: Discussionsupporting

confidence: 90%

Duplex sonography for detection of deep vein thrombosis of upper extremities: a 13-year experience

Chung

Luk²,

et al. 2015

Hong Kong Med J

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Section: Discussionsupporting

confidence: 90%

Duplex sonography for detection of deep vein thrombosis of upper extremities: a 13-year experience

Chung

Luk²,

et al. 2015

Hong Kong Med J

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“…Acute thrombosis can result, which is often superimposed on chronic venous stenosis. 2 Paget-Schroetter syndrome is relatively rare, with an annual incidence of 1-2 cases per 100 000 population. 2 Nevertheless, it is important to recognize the clinical presentation and understand management options to optimize patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…2 Paget-Schroetter syndrome is relatively rare, with an annual incidence of 1-2 cases per 100 000 population. 2 Nevertheless, it is important to recognize the clinical presentation and understand management options to optimize patient outcomes. As will be discussed later, treatment with anticoagulation alone will not relieve the intermittent obstruction, and therefore there is a risk of persistent symptoms and recurrence of thrombosis.…”

Section: Discussionmentioning

confidence: 99%

“…5 Some patients who experience intermittent obstruction of venous outflow or recurrent partial thrombosis may notice the intermittent occurrence of similar, but less severe symptoms before the acute symptoms of Paget-Schroetter syndrome develop. 2 Physical examination reveals edema of the affected upper extremity, which can be associated with distal cyanosis of the hands and fingers. Dilated subcutaneous collateral veins over the anterior shoulder may also be seen.…”

Section: Clinical Presentationmentioning

confidence: 99%

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Spontaneous deep vein thrombosis in the upper extremity of a 45-year-old woman

Stein

McLeod

Devine

2014

CMAJ

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A 45-year-old woman presented to her family doctor following a three-day history of acute-onset, progressive swelling and sensation of heaviness in her left upper extremity. In addition, she described pleuritic chest pain and dyspnea on exertion. Five days before presentation, she had been lifting heavy furniture and boxes and had performed her regular exercise routine that involved lifting 10-and 15-pound weights overhead. She had no history of thrombosis and no family history of clotting disorders. Her medical history included Hashimoto thyroiditis and remote iron deficiency anemia secondary to menorrhagia. Cancer screening had yielded normal results on a Papanicolaou test and a colonoscopy performed three years earlier. She had no recent immobilization, surgery or long-distance travel and was not taking supplemental estrogen. The patient was referred to the emergency department for evaluation of suspected deep vein thrombosis (DVT) in her left upper extremity and pulmonary embolus.In the emergency department, she had a regular heart rate of 96 beats/min and an oxygen saturation of 95% on room air. Her temperature and blood pressure were within normal limits. There was obvious swelling of the entire left upper extremity, dilated subcutaneous collateral veins over the anterior shoulder, and mild cyanosis in the hand and fingers. Neurologic and arterial examinations of the upper extremities yielded normal findings. Venous duplex ultrasonography showed an occlusive thrombus in the left subclavian and axillary veins. Computed tomography pulmonary angiography showed pulmonary emboli in the bilateral subsegmental arteries. The patient was admitted, and treatment with low-molecular-weight hep arin was started.The following morning, the patient underwent peripheral venography (Figure 1) with catheter-directed thrombolysis using a tissue plasminogen activator. She subsequently received ongoing anticoagulation with intravenous unfractionated heparin. A follow-up venogram 24 hours after the thrombolysis showed resolution of the clot; however, severe stenosis of the left subclavian vein was noted. Angioplasty of the stenotic area was only partially successful, leaving residual stenosis of the subclavian vein in the neutral position, with dynamic occlusion on abduction of the left upper extremity (Figure 2). Two days later, the patient was discharged home and prescribed low-molecularweight heparin.Two months after discharge, the patient underwent an uncomplicated transaxillary resection of the left first rib to relieve compression of the subclavian vein. Venography performed one month later showed resolution of the subclavian vein stenosis and of the dynamic occlusion (Figure 3). In discussion with her treating physician, the patient elected to complete a further three months of anticoagulation with therapeutic doses of low-molecular-weight heparin instead of transitioning to oral anticoagulation following her surgery. She experienced good functional recovery of her left upper extremity, with no recurrence of DVT.

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“…PAGET-SCHROETTER SYNDROME Background PSS (otherwise known as thoracic outlet syndrome and previously known as effort thrombosis) is an uncommon cause of DVT of the subclavian vein, most commonly seen as a consequence of chronic compression of the subclavian vein at the level of the thoracic outlet [4,5]. Primary axillary-subclavian vein thrombosis was first described by Paget in 1875 and Von Schroetter in 1884 and it was named the "Paget-Schroetter syndrome" by Hughes [6] in 1948.…”

mentioning

confidence: 99%

Venous compression syndromes: clinical features, imaging findings and management

Butros¹,

Liu²,

Oliveira³

et al. 2013

BJR

134

206

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Extrinsic venous compression is caused by compression of the veins in tight anatomic spaces by adjacent structures, and is seen in a number of locations. Venous compression syndromes, including Paget-Schroetter syndrome, Nutcracker syndrome, May-Thurner syndrome and popliteal venous compression will be discussed. These syndromes are usually seen in young, otherwise healthy individuals, and can lead to significant overall morbidity. Aside from clinical findings and physical examination, diagnosis can be made with ultrasound, CT, or MR conventional venography. Symptoms and haemodynamic significance of the compression determine the ideal treatment method.

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A comprehensive review of Paget-Schroetter syndrome

Cited by 350 publications

References 64 publications

Duplex sonography for detection of deep vein thrombosis of upper extremities: a 13-year experience

Duplex sonography for detection of deep vein thrombosis of upper extremities: a 13-year experience

Spontaneous deep vein thrombosis in the upper extremity of a 45-year-old woman

Venous compression syndromes: clinical features, imaging findings and management

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