Effort thrombosis of the upper extremity in a young sportsman: Paget–Schroetter syndrome

Abstract

Paget-Schroetter syndrome is the spontaneous thrombosis of the axillary/subclavian vein. A 16-year-old male presented with acute onset of right upper limb swelling after vigorous weight training. A venogram confirmed the diagnosis of Paget–Schroetter syndrome. He was started on intravenous thrombolytics followed by oral anticoagulation therapy. His symptoms resolved and he was symptom free at six-month follow-up. Thrombolytics and anticoagulation is the most widely accepted first-line therapy for this syndrome. Defining any anatomical anomaly as the predisposing factor in this condition is essential in the selection of which patients will benefit from thoracic outlet decompression.

Antithrombotic Therapy in Neonates and Children

“…[502][503][504][505][506][507][508][509] However, in the upper venous system, thoracic outlet syndrome, eponymously named Paget-Schroetter syndrome, are believed to be due to chronic trauma to the subclavian vein secondary to reduced anatomic space for the vein usually as a result of an abnormal relationship with the fi rst rib, abnormal fi brous bands or muscle development in athletes . [510][511][512][513][514][515][516][517][518][519] Management of the venous thrombosis and the underlying structural abnormality has included acute anticoagulation; both local and systemic thrombolysis through a number of techniques; percutaneous angioplasty; thrombectomy; venous reconstruction; and in the case of PagetSchroetter syndrome, decompression of the thoracic inlet through removal of relevant bone and muscle. No randomized trials have been conducted.…”

Upper extremity deep vein thrombosis presenting to a chiropractic clinic: a description of 2 cases

“…4 The term PSS was first used by Hughes in 1949 in his review of 320 cases of subclavian vein thrombosis. 5,8 Sir James Paget identified the first case in 1875 in a patient with acute arm pain and swelling. 5 Independently, van Schroetter reported a similar case in 1884 in a healthy individual after painting.…”

“…5,8 Sir James Paget identified the first case in 1875 in a patient with acute arm pain and swelling. 5 Independently, van Schroetter reported a similar case in 1884 in a healthy individual after painting. 5 It appeared to the physicians that vascular damage could occur in otherwise healthy individuals following repetitive upper limb stretching.…”

“…5 It appeared to the physicians that vascular damage could occur in otherwise healthy individuals following repetitive upper limb stretching. 5 Paget-Schroetter syndrome has been classified as a disorder with many etiologies 1 ; however, it is most commonly induced via activity or physical effort 6 in young and otherwise healthy individuals. Therefore, it most commonly affects the dominant arm.…”

“…[1][2][3] Upper extremity deep vein thromboses are categorized as primary or secondary, and relate to UEDVT affecting the subclavian (18%-69%), axillary (5%-42%), or brachial (4%-13%) veins. [1][2][3][4][5][6][7] Approximately one-third of UEDVT s are primary in nature, which include idiopathic thromboses or effort-induced thromboses. 2,4 Effort or activity-related UEDVT are sometimes referred to as Paget-Schroetter syndrome (PSS).…”