Paget-Schroetter syndrome in athletes: a comprehensive and systematic review

Keller, R; Croswell, Damari P.; Medina, Giovanna; Cheng, Timothy; Oh, Luke S.

doi:10.1016/j.jse.2020.05.015

Cited by 9 publications

(8 citation statements)

References 49 publications

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“…Primary UEDVT, which accounts for only 20% of all cases of UEDVT, is also known as Paget-Schroetter syndrome and is characteristically induced in young adults by excessive activity of the upper extremity. 21 Secondary UEDVT is mostly associated with central venous catheters, malignancy, radiotherapy and trauma. 2 PE occurs in approximately 9% of patients with UEDVT, sometimes resulting in death.…”

Section: Discussionmentioning

confidence: 99%

Platelet/Lymphocyte Ratio Predicted Long-Term Prognosis for Acute Upper Extremity Deep Vein Thrombosis from a Retrospective Study

Liu¹,

Sun²,

Jia³

2023

JIR

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Background In this study, we aimed to determine the mortality risk factors and whether placement of a vena cava filter improves the prognosis of acute upper extremity deep vein thrombosis (UEDVT). Methods Clinical data and follow-up results were retrospectively analyzed. Cox regression analysis was conducted to identify the risk factors associated with all-cause mortality in all patients and subgroups of patients. Results are expressed as hazard ratio (HR) with 95% confidence intervals (95% CI). Receiver operating characteristic curves (ROC) were used to determine the optimal cut-off value. Kaplan–Meier survival curves were constructed and compared by the Log rank test. Results The study cohort comprised 109 patients of median age 56 years (47.5, 64.5). The median follow-up time was 25 months (8, 47): 39 patients (35.8%) had died by 12 months, 55 (50.5%) by 36 months, and 60 (55%) by the end of follow-up. Presence of malignancy (HR: 5.882, 95% CI: 2.128–16.667), D-dimer (HR: 1.56, 95% CI: 1.09–1.94), platelet/lymphocyte ratio (PLR; HR: 2.02, 95% CI: 1.15–3.54), and the systemic immune/inflammatory index (SII; HR: 1.471, 95% CI: 1.062–1.991) were identified as independent risk factors for mortality. Subgroup analysis of patients with malignancy determined gender (HR: 2.936, 95% CI: 1.599–5.393) and PLR (HR: 1.427,95% CI: 1.023–1.989) as independent risk factors. Kaplan–Meier analysis showed that the mortality rate was much higher in patients with malignancy, high D-dimer (≥ 0.92ug/mL), high PLR (≥ 291) and high SII (≥ 1487). However, there was no significant difference between patients with and without vena cava filters. Conclusion In this study, we identified PLR as an new independent predictor of mortality in patients with acute UEDVT. Emergency placement of a vena cava filter did not improve long-term prognosis.

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Section: Discussionmentioning

confidence: 99%

Platelet/Lymphocyte Ratio Predicted Long-Term Prognosis for Acute Upper Extremity Deep Vein Thrombosis from a Retrospective Study

Liu¹,

Sun²,

Jia³

2023

JIR

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“…Although ET occurs in about 2 per 100,000 people per year, it accounts for 10% to 20% of all upper extremity venous thrombosis (1,3). ET typically presents in athletes who perform repetitive overhead motions, most commonly baseball and weightlifting athletes (4). The thoracic outlet is demarcated by the clavicle (superior border), costoclavicular ligament (medial border), first rib (inferior border), and the anterior scalene muscle (posterolateral border) (1).…”

Section: Discussionmentioning

confidence: 99%

“…The presentation of ET is usually acute in onset and during or shortly after an episode of physical activity (1,4). Symptoms such as swelling, discomfort, and "heaviness" of the affected extremity are common (1,4).…”

Section: Discussionmentioning

confidence: 99%

Effort-Associated Thrombosis: Imaging Is Key when Suspicion Is High. A Case Report

Hollabaugh

Bowman

2022

Curr Sports Med Rep

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“…Paget-Schroetter Syndrome is a type of primary DVT commonly seen in athletes with thoracic outlet syndrome 163,164 . In this disorder, athletes who frequently perform repetitive external rotation and abduction of the shoulder develop a thrombosis in the axillosubclavian vein.…”

Section: Filippo Randelli Alberto Fioruzzimentioning

confidence: 99%

“…In this disorder, athletes who frequently perform repetitive external rotation and abduction of the shoulder develop a thrombosis in the axillosubclavian vein. They often present after a period of physical activity with acute pain, discoloration, swelling, and heaviness of the affected extremity 163 .…”

Section: Filippo Randelli Alberto Fioruzzimentioning

confidence: 99%

Recommendations from the ICM-VTE: Shoulder & Elbow

2022

Journal of Bone and Joint Surgery

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The ICM-VTE Shoulder & Elbow Delegates* Question: 1 -Concerning VTE risk, which surgeries can be considered major, and which surgeries can be considered non-major in shoulder and elbow surgery?Response/Recommendation: Shoulder arthroscopy, nonfracture related shoulder arthroplasty, and all elbow procedures can be considered non-major venous thromboembolism (VTE) risk. Fracture related shoulder procedures can be considered major VTE risk.Strength of Recommendation: Limited.Delegates vote: Agree 93.94% Disagree 6.06% Abstain 0.00% (Strong Consensus)Rationale: VTE following shoulder and elbow surgery are rare events. One study reported for all upper extremity deep venous thromboses (DVT) to represent 1% to 4% of all DVT 1 . In the shoulder, surgeries can be divided into arthroscopic, non-fracture shoulder arthroplasty, and fracture related surgeries. In the elbow, surgeries can be divided into arthroscopy, fracture related, and arthroplasty. With respect to these surgeries, several studies have reported VTE rates, however, a majority of this information comes from a collection of level 3 and level 4 evidence along with registry studies.In shoulder arthroscopy, VTE rates are low with reported rates ranging from 0.011% to 0.38% 2-6 . Kuremsky et al., in a retrospective study of 2,872 patients undergoing shoulder arthroscopy reported VTE rate of 0.24% 2 . Jameson et al., in a registry study out of the United Kingdom reported 0.011% VTE rate in a retrospective review of 65,302 shoulder arthroscopy cases 3 . Similarly, Brislin et al., reported VTE rate of 0.38% in a consecutive series of 263 arthroscopic rotator cuff repairs (RCR) 4 . These VTE rates following arthroscopic RCR were similar to rates reported by Hoxie et al., (0.26%) 5 . Additionally, open instability surgeries also comprise higher VTE risk than their arthroscopic counterparts. Goodloe et al., in a registry study compared arthroscopic Bankart repair, open Bankart repair, and Latarjet-Bristow procedure with reported VTE rates of 0.1%, 0.0%, and 0.8%, respectively 7 . Thus, shoulder arthroscopy procedures can be considered non-major concerning VTE risk.

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Paget-Schroetter syndrome in athletes: a comprehensive and systematic review

Cited by 9 publications

References 49 publications

Platelet/Lymphocyte Ratio Predicted Long-Term Prognosis for Acute Upper Extremity Deep Vein Thrombosis from a Retrospective Study

Platelet/Lymphocyte Ratio Predicted Long-Term Prognosis for Acute Upper Extremity Deep Vein Thrombosis from a Retrospective Study

Effort-Associated Thrombosis: Imaging Is Key when Suspicion Is High. A Case Report

Recommendations from the ICM-VTE: Shoulder & Elbow

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