Paget-Schroetter Syndrome

Paget-Schroetter syndrome

Paget–Schroetter disease, is a form of upper extremity deep vein thrombosis (DVT), a medical condition in which blood clots form in the deep veins of the arms. These DVTs typically occur in the axillary or subclavian veins.

Paget-Schroetter syndrome or effort thrombosis describes venous thoracic outlet syndrome progressing to the point of subclavian vein thrombosis. Typically if the diagnosis and treatment can be started early, it has minimal long-term sequelae but if ignored is associated with significant long-term morbidity in the affected limb.

Dynamic occlusion of the subclavian vein

The subclavian vein is highly vulnerable to injury as it passes by the junction of the first rib and clavicle in the anterior-most part of the thoracic outlet. In addition to extrinsic compression, repetitive forces in this area frequently lead to fixed intrinsic damage and extrinsic scar tissue formation.

Once the primary thrombosis is recognized, catheter-directed thrombolytic therapy is usually successful if initiated within ten to 14 days of clot formation, but often unmasks an underlying lesion that often requires definitive treatment.

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