A Case Report of Primary Subclavian-Axillary Vein Thrombosis

The patient, a 34-year-old woman, had a sudden swelling of the right upper extremity and was diagnosed as having Paget-Schroetter syndrome after detection of complete obstruction of the right subclavian vein by phlebography. Anticoagulant and fibrinolytic therapy was immediately performed, resulting in improvement of her clinical condition and satisfactory development of collateral circulations. Paget-Schroetter syndrome is a rare disease, and 29 cases including this one have been reported in Japan. Investigation of cases reported from Europe and America as well as from Japan revealed that the symptom often occurs in the right upper extremity of males in their 20s and 30s and that the initial symptom is so characteristic that the diagnosis is easy, requiring phlebography for definite diagnosis. As for treatment, it is difficult to succeed in thrombectomy, possibly causing a complicating pulmonary embolism, and it is consequently thought to be important to begin fibrinolytic therapy combined with anticoagulant therapy for development of collateral circulations, immediately after the occurrence.