Paget-Schroetter: Primary Axillo-subclavian Vein Thrombosis in a Young Patient

Abstract

Upper extremity (UE) deep venous thrombosis (DVT) is much less common than lower extremity DVT. Primary UE DVT, that which occurs in the absence of known risk factors is quite rare. We present a case of Paget-Schroetter Syndrome (PSS) also known as “Effort Thrombosis,” in a healthy young woman likely brought on by thoracic outlet syndrome (TOS). Our patient developed an UE DVT with minimal symptoms. Ultrasound, and then angiogram demonstrated a dense, long clot in the axillo-subclavian vein. Symptoms improved after catheter-directed thrombolysis although it was only partially successful. A narrowed region of the subclavian vein persists where it exits the thoracic outlet. Clinicians need to be aware of the unusual diagnosis as treatment can improve symptoms and facilitate recovery.