title: Venous thoracic outlet compression and the Paget-Schroetter syndrome: a review and recommendations for management.
abstract: Paget Schroetter syndrome, or effort thrombosis of the axillosubclavian venous system, is distinct from other forms of upper limb deep vein thrombosis. It occurs in younger patients and often is secondary to competitive sport, music, or strenuous occupation. If untreated, there is a higher incidence of disabling venous hypertension than was previously appreciated. Anticoagulation alone or in combination with thrombolysis leads to a high rate of rethrombosis. We have established a multidisciplinary protocol over 15 years, based on careful patient selection and a combination of lysis, decompressive surgery, and postoperative percutaneous venoplasty. During the past 10 years, a total of 232 decompression procedures have been performed. This article reviews the literature and presents the Exeter Protocol along with practical recommendations for management.
authors: Department of Surgery, Exeter Vascular Service and Peninsula College of Medicine and Dentistry, The Royal Devon and Exeter Hospital and Peninsula Medical and Dental School, Barrack Road, Exeter, Devon EX2 5DW, UK. j.f.thompson@exeter.ac.uk
authors: J F
authors: JF
authors: Thompson
authors: R J
authors: RJ
authors: Winterborn
authors: S
authors: S
authors: Bays
authors: H
authors: H
authors: White
authors: D C
authors: DC
authors: Kinsella
authors: A F
authors: AF
authors: Watkinson
mesh_terms: D006801:Humans; D012272:Ribs / Q000601:surgery; D013901:Thoracic Outlet Syndrome / Q000601:surgery*; D056824:Upper Extremity Deep Vein Thrombosis / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods