Journal of Vascular Nursing
Volume 24, Issue 4 , Pages 116-126 , December 2006

Effort thrombosis (Paget-Schroetter syndrome) in active young adults: Current concepts in diagnosis and treatment

Presented at: Society of Vascular Nursing, 24th Annual National Convention, Las Vegas, Nevada, April 27, 2006.

  • Nancy D. Shebel, NP-c, MSN, FNP, CVN

      Affiliations

    • Corresponding Author InformationAddress reprint requests to Nancy D. Shebel, NP-c, MSN, CVN, University of Southern California, Center for Vascular Care, 1510 San Pablo Suite 514, Los Angeles, CA 90033.
  • ,
  • Alice Marin, MSN, ACNP, RNFA

References 

  1. Sevestre MA, Kalka C, Irwin WT, et al. Paget-Schroetter syndrome: what to do?. Catheter Cardiovasc Interv. 2003;59:71–76
  2. Azakie A, McElhinney DB, Thompson RW, et al. Surgical management of subclavian-vein effort thrombosis as a result of thoracic outlet compression. J Vasc Surg. 1998;28:777–786
  3. Angle N, Gelabert HA, Farooq MM, et al. Safety and efficacy of early surgical decompression of the thoracic outlet for Paget-Schroetter syndrome. Ann Vasc Surg. 2001;15:37–42
  4. Thomas IH, Zierler BK. An integrative review of outcomes in patients with acute primary upper extremity deep venous thrombosis following no treatment or treatment with anticoagulation, thrombolysis, or surgical algorithms. Vasc Endovasc Surg. 2005;39:163–174
  5. Sanders RJ, Hammond SL. Subclavian vein obstruction without thrombosis. J Vasc Surg. 2005;41:285–290
  6. Adelman MA, Stone DH, Riles TS, et al. A multidisciplinary approach to the treatment of Paget-Schroetter Syndrome. Ann Vasc Surg. 1997;11:149–154
  7. Joffe HV, Goldhaber SZ. Upper-extremity deep vein thrombosis. Circulation. 2002;106:1874–1880
  8. Lee WA, Hill BB, Harris EJ, et al. Surgical intervention is not required for all patients with subclavian vein thrombosis. J Vasc Surg. 2000;32:57–67
  9. Martinelli I, Cattaneo M, Panzeri D, et al. Risk factors for deep venous thrombosis of the upper extremities. Ann Intern Med. 1997;126:707–711
  10. Vijaysadan V, Zimmerman AM, Pajaro RE. Paget-Schroetter syndrome in the young and active. J Am Board Fam Pract. 2005;18:314–319
  11. Yanturali S, Aksay E, Holliman J. Clinical pearls: left arm swelling. Acad Emerg Med. 2004;11:281–283
  12. Urschel HM, Razzuk MA. Paget-Schroetter syndrome: what is the best management?. Ann Thorac Surg. 2000;69:1663–1669
  13. Bliss S, Weinberger S, Meier M, et al. The unusual suspect. N Engl J Med. 2002;347:1876–1881
  14. Urschel HM, Patel AN. Paget-Schroetter syndrome therapy: failure of intravenous stents. Ann Thorac Surg. 2003;75:1693–1696
  15. Baarslag HJ, van Beek EJ, Koopman MM, et al. Prospective study of color duplex ultrasonography compared with contrast venography in patients suspected of having deep vein thrombosis of the upper extremities. Ann Intern Med. 2002;136:865–872
  16. Lee MC, Grassi CJ, Belkin M, et al. Early operative intervention after thrombolytic therapy for primary subclavian vein thrombosis: an effective treatment approach. J Vasc Surg. 1998;27:1101–1108
  17. Machleder HI. Vascular disease of the upper extremity and the thoracic outlet syndromes. In:  Moore W editors. Vascular surgery: a comprehensive review. 4th ed.. Philadelphia: WB Saunders Company; 1993;p. 600–603
  18. Sternbach Y, Green RM. Endovascular and surgical management of acute axillary-subclavian vein thrombosis. In:  Glovicski P,  Yao JST editor. Handbook of venous disorders; guidelines of the American venous forum. 2nd ed.. London: Arnold; 2001;p. 203–209
  19. AbuRahma AF, Short YS, White JF, et al. Treatment alternatives for axillary-subclavian vein thrombosis: long term follow-up. Cardiovasc Surg. 1996;4(6):783–787
  20. Hughes ESR. Venous obstruction in the upper extremity (Paget-Schtoetter’s syndrome): a review of 320 cases. International Abstract of Surgery. 1949;88:89–127
  21. Adams JT, DeWeese JA, Mahoney EB, et al. Intermittent subclavian vein obstruction without thrombosis. Surg. 1968;147–165
  22. Adams JT, DeWeese . “Effort thrombosis of the axillary and subclavian veins. J Trauma. 1971;11:923–930
  23. Adams JT, McEvoy RK, DeWeese JA. Primary deep venous thrombosis of upper extremity. Arch Surg. 1965;91:29–42
  24. Tinley NL, Griffiths HJG, Edwards EA. Natural history of major venous thrombosis of the upper extremity. Arch Surg. 1970;101:792–796
  25. Arko FR, Harris JE, Zarins CR, et al. Vascular complications in high performance athletes. J Vasc Surg. 2001;33:935–942
  26. Lokanathan R, Salvian AJ, Chen JC, et al. Outcome after thrombolysis and selective thoracic outlet decompression for primary axillary vein thrombosis. J Vasc Surg. 2001;33:783–788
  27. Machleder HI. Evaluation of a new treatment strategy for Paget-Schroetter syndrome: spontaneous thrombosis of the axillary-subclavian vein. J Vasc Surg. 1993;17:305–317
  28. Sabeti S, Schillinger M, Mlekusch W, et al. Treatment of subclavian-axillary vein thrombosis: long-term outcome of anticoagulation versus systemic thrombolysis. Thromb Res. 2003;108:279–285
  29. Molina JE. A new surgical approach to the innominate and subclavian vein. J Vasc Surg. 1998;27:576–581
  30. Schneider DB, Dimuzio PJ, Martin ND, et al. Combination treatment of venous thoracic outlet syndrome: open surgical decompression and intraoperative angioplasty. J Vasc Surg. 2004;40:599–603
  31. MacVittie BA. Thoracic outlet surgery. Vascular surgery. St Louis: Mosby; 1998;
  32. Kreienberg PB, Chang BB, Darling RC, et al. Long-term results in patients treated with thrombolysis, thoracic inlet decompression, and subclavian vein stenting for Paget-Schroetter syndrome. J Vasc Surg. 2001;33:S100–S105
  33. Hood DB, Kuehne J, Yellin AE, Weaver FA. Vascular complications of thoracic outlet syndrome. Am Surg. 1997;63:913–917

 Financial assistance: No grants or other financial assistance was provided.

PII: S1062-0303(06)00118-X

doi: 10.1016/j.jvn.2006.09.003

Journal of Vascular Nursing
Volume 24, Issue 4 , Pages 116-126 , December 2006