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Paget-Schroetter syndrome

Lookup NU author(s): Professor Gerard Stansby


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Objective: To review current approaches to investigation and management of Paget-Schroetter syndrome (PSS). Methods: Relevant clinical studies and reports were searched for using MEDLINE and Embase databases and cross-referenced articles. Articles were extracted using keywords by the two authors independently. Principal findings: There is growing evidence of functional or positional anatomical defects, which lead to subtle intimal injury and a tendency for recurrence or poor outcome. Management of PSS remains controversial. Anticoagulation as a stand-alone treatment has lost favour. Active treatment with thrombolysis followed by consideration of thoracic decompression is recommended by most in the recent literature. Thrombolytic therapy appears to be a safe and efficacious method of establishing immediate patency of the axillary/subclavian vein. The timing and indications of decompression surgery are yet to be defined clearly. There are no randomized trials of treatment or management strategies in PSS. Conclusions: Treatment of PSS remains contentious. Most authors recommend active treatment with thrombolysis followed by thoracic decompression. Multicentre randomized trials are needed. © 2003 Royal Society of Medicine Press.

Publication metadata

Author(s): Khan SN, Stansby G

Publication type: Review

Publication status: Published

Journal: Phlebology

Year: 2003

Volume: 18

Issue: 1

Pages: 2-11

Print publication date: 01/01/2003

ISSN (print): 0268-3555

ISSN (electronic): 1758-1125


DOI: 10.1258/026835503321236849