Clinical Case Database / Category: Patient Management

Paget Schroetter syndrome

Publication details

Dr Toni Bryant MBChB, Mr Andrew Torrance MBChB MRCS, Dr Penny Slanney MBChB MRCS. (Ed) FRCR, Mr Richard Downing BSc MD FRCS
Foundation Years Journal, volume 5, issue 1, p.62 (123Doc Education, London, February 2011)

Abstract

The Paget-Schroetter syndrome is defined by acute primary thrombosis of the subclavian-axillary vein complex . It usually effects otherwise healthy young adults who present with acute swelling and cyanosis of the upper limb. Management can be complex and requires both initial treatment of the acute thrombosis as well as the correction of any underlying anatomical abnormality that has predisposed to the condition. Our case based discussion describes the presentation of an 18-year-old male with a subclavian-axillary venous thrombosis and focuses on the diagnosis and management of the Paget-Schroetter syndrome. It also highlights the importance of discussing treatment options fully with patients to allow them to make informed decisions about their treatment.

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Authors

Dr Toni Bryant MBChB

FY1 Vascular Surgery
Worcestershire Royal Hospital
Worcestershire Acute NHS Trust

Mr Andrew Torrance MBChB MRCS

SPR General and Vascular Surgery
Worcestershire Royal Hospital
Worcestershire Acute NHS Trust

Dr Penny Slanney MBChB MRCS. (Ed) FRCR

Consultant Interventional Radiologist
Worcestershire Royal Hospital
Worcestershire Acute NHS Trust

Mr Richard Downing BSc MD FRCS

Consultant Vascular Surgeon
Worcestershire Royal Hospital
Worcestershire Acute NHS Trust
Charles Hastings Way
Worcester
WR5 1DD

References

1. Molina JE, Hunter DW, Dietz CA. Paget-Schroetter syndrome treated with thrombolytics and immediate surgery. J Vasc Surgery 2007; 45:328-34.
2. Melby SJ, Vedantham S, Narr VR, Paletta GA, Khoo-Summers L, Driskill M and Thompson R. Comprehensive surgical management of the competitive athlete with effort thrombosis of the subclavian vein (Paget-Schroetter syndrome). J Vasc Surg 2008; 47:809-21.
3. Lee JT, Karwowski JK, Harris J, Hakoos JS and Olcott C. Long-term thrombotic recurrence after nonoperative management of Paget-Schroetter syndrome. J Vasc Surg 2006; 43:1236-43.
4. Illig KA and Doyle AJ. A comprehensive review of Paget-Schroetter syndrome. J Vasc Surg 2010; 51:1538-47.
5. Prandoni P et al. Upper extremity deep vein thrombosis. Pulm Med 1999;5:222-6.
6. Landry GJ and Liem TK. Endovascular management of Paget-Schroetter syndrome. Vascular 2007; 15:290-6.
7. Chin P, Zimmerman PT, and Grant EG. Sonographic evaluation of upper extremity deep vein thrombosis. J Ultrasound Med 2005; 24:829-38.

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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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