Original articles: General thoracicPaget-Schroetter syndrome: what is the best management?
Section snippets
Material and methods
Clinical manifestations of “effort” thrombosis of the axillary subclavian vein in the acute and subacute phases were evaluated in 312 extremities of 294 patients, 18 being bilateral. (For the remainder of the discussion, the number of the extremities will be assessed rather than the number of patients.) There were 154 female and 140 male extremities, ranging in age from 16 to 51 years, with a mean of 32 years. Trauma was involved in 125 extremities. Two hundred one had unusual occupations that
Results
Results were evaluated as excellent, good, fair, or poor according to the criteria in Table 3and are summarized in Table 4. In group I, 10 extremities of the 35 showed substantial improvement with anticoagulation and evaluation therapy. In 25 extremities, symptoms either were not completely improved or recurred. The pain, swelling, and dysfunction usually occurred when the patient returned to the job that had produced the difficulty initially. Twenty-one of those required first rib resection,
Comment
Historically, Sir James Paget [2] in 1875 in London and Von-Schroetter [1] in 1884 in Vienna described this syndrome of thrombosis of the axillary-subclavian vein, which bears their names. The word “effort” [14] was added to thrombosis because of the frequent association with exertion superimposed on anatomical compressive elements in the thoracic outlet. Trauma, unusual occupations requiring repetitive muscular activity, as has been observed in professional athletes, linotype operators,
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