Key result
Primary thrombosis of the axillary vein can be caused by muscular effort, and surgical thrombectomy is the therapy of choice if executed before the seventh day after onset.
Case Report (n=1)
Surgical thrombectomy is the preferred treatment for effort-induced axillary vein thrombosis if performed within 7 days of onset; otherwise, medical management is indicated despite a high risk of postphlebitic syndrome.
May support early thrombectomy in effort-induced axillary vein thrombosis; leaves open need for prospective validation before practice change.
SummaryA case of primary thrombosis of the axillary vein in a 26-year old volleyball-player is reported. The role of effort in the pathogenesis of the syndrome is controversial. In some cases however the influence of stress is without doubt.In this case thrombosis seemed to have been caused when the patient was performing the “smash” technique by narrowing of the costoclavicular space with compression of the subclavian vein.In many patients different points of potential compression exist where the vein can be occluded by some movements of the shoulder and the arm.The importance of sympathetic influence is discussed.Surgical thrombectomy is the therapy of choice if this procedure can be executed before the seventh day after the onset of the thrombosis.Surgery does not benefit the other cases, which require medical treatment with anticoagulants and with rest and elevation of the arm.Nevertheless 75% of patients develop a postphle-bitic syndrome which remains difficult to treat.
No takes yet. Share an insight, caveat, or question.
Bossaert et al. (1976) conducted a case report in Primary thrombosis of the axillary vein (Paget-Von Schroetter syndrome) (n=1). Surgical thrombectomy vs. Medical treatment with anticoagulants was evaluated. Primary thrombosis of the axillary vein can be caused by muscular effort, and surgical thrombectomy is the therapy of choice if executed before the seventh day after onset.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: