Multidisciplinary management of Paget-Schroetter syndrome. A case series of eight patients

Arch Bronconeumol. 2015 Aug;51(8):e41-3. doi: 10.1016/j.arbres.2014.09.003.
[Article in English, Spanish]

Abstract

Paget-Schroetter syndrome (PSS) in the context of upper extremity deep venous thrombosis (DVT) is an uncommon but potentially very serious condition affecting young, healthy adults, in which secondary post-thrombotic syndrome (PTS) can be a complication with major implications. The best treatment option remains controversial, with current guidelines recommending anticoagulation for at least 3 months. However, an incidence of PTS of approximately 50% after 6 months, 30% after 1 year and 25% after 2 years has been found using this therapeutic approach. Consequently, specialized units recommend local thrombolysis and early decompressive surgery. We describe a series of eight cases treated in this way. None of the patients showed signs of complications, and an early return to regular activities with no PTS was observed in 90% of cases.

Keywords: Effort thrombosis; Paget-Schroetter syndrome; Síndrome de Paget-Schroetter; Síndrome de la salida del tórax; Thoracic outlet syndrome; Trombosis de esfuerzo; Trombosis venosa profunda de extremidad superior; Upper extremity deep vein thrombosis.

MeSH terms

  • Adolescent
  • Adult
  • Anticoagulants / administration & dosage
  • Anticoagulants / therapeutic use*
  • Combined Modality Therapy
  • Cumulative Trauma Disorders / drug therapy
  • Cumulative Trauma Disorders / etiology
  • Cumulative Trauma Disorders / surgery
  • Decompression, Surgical*
  • Disease Management*
  • Disease-Free Survival
  • Endovascular Procedures
  • Female
  • Heparin, Low-Molecular-Weight / administration & dosage
  • Heparin, Low-Molecular-Weight / therapeutic use*
  • Humans
  • Interdisciplinary Communication
  • Male
  • Neck Muscles / surgery
  • Occupational Diseases / drug therapy
  • Occupational Diseases / etiology
  • Occupational Diseases / surgery
  • Patient Care Team
  • Postthrombotic Syndrome / prevention & control*
  • Prospective Studies
  • Recurrence
  • Ribs / surgery
  • Thrombolytic Therapy*
  • Upper Extremity Deep Vein Thrombosis / drug therapy
  • Upper Extremity Deep Vein Thrombosis / etiology
  • Upper Extremity Deep Vein Thrombosis / surgery
  • Upper Extremity Deep Vein Thrombosis / therapy*
  • Weight Lifting
  • Young Adult

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight