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Recurrence of Paget-Schroetter Syndrome: A Rare Case Report and Review of Literature

Paget-Schroetter syndrome (PSS) is a primary upper extremity deep vein thrombosis (DVT) that occurs with no significant risk factors, mostly in a young and healthy patient. Treatment of this disease is discussed heavily in the literature and the optimal treatment method is still being debated. Here,...

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Autores principales: Akoluk, Arda, Douedi, Steven, Dattadeen, Jaraad, Patel, Ishan, Mushtaq, Arman, Levitt, Michael, Asif, Arif, Hossain, Mohammad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383678/
https://www.ncbi.nlm.nih.gov/pubmed/34434331
http://dx.doi.org/10.14740/jmc3416
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author Akoluk, Arda
Douedi, Steven
Dattadeen, Jaraad
Patel, Ishan
Mushtaq, Arman
Levitt, Michael
Asif, Arif
Hossain, Mohammad
author_facet Akoluk, Arda
Douedi, Steven
Dattadeen, Jaraad
Patel, Ishan
Mushtaq, Arman
Levitt, Michael
Asif, Arif
Hossain, Mohammad
author_sort Akoluk, Arda
collection PubMed
description Paget-Schroetter syndrome (PSS) is a primary upper extremity deep vein thrombosis (DVT) that occurs with no significant risk factors, mostly in a young and healthy patient. Treatment of this disease is discussed heavily in the literature and the optimal treatment method is still being debated. Here, we present a patient with PSS treated with balloon angioplasty, thrombolysis and treatment with an oral thrombin inhibitor (apixaban) who developed recurrence of PSS. A 38-year-old white male with no past medical history, presented to an urgent care center with sudden onset axillary pain and an axillary lump that was treated with outpatient antibiotics. Extensive deep venous thrombosis was diagnosed with computed tomography (CT) and ultrasound. He underwent percutaneous pharmacomechanical thrombectomy. Postprocedural angiogram showed significant improvement in the caliber of the axillary and subclavian veins where they crossed the first rib. He was discharged on apixaban and underwent removal of his first rib 1 month later. He returned 3 weeks later with recurrence of right arm pain and swelling. Repeat ultrasound showed thrombus in the right arm and venogram confirmed 80% stenosis at the subclavian vein as it enters the innominate vein. He was again treated with placement of a thrombolytic catheter and overnight thrombolysis of the central venous circulation on the right-side upper extremity balloon angioplasty of the subclavian vein, axillary vein, and basilic vein. He is disease-free for 6 months. Recurrence of PSS after surgical removal of rib, thrombectomy, thrombolysis while using apixaban is very rare. This is the first case to our knowledge presented with recurrent PSS treated with apixaban, early rib resection, balloon angioplasty and thrombectomy.
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spelling pubmed-83836782021-08-24 Recurrence of Paget-Schroetter Syndrome: A Rare Case Report and Review of Literature Akoluk, Arda Douedi, Steven Dattadeen, Jaraad Patel, Ishan Mushtaq, Arman Levitt, Michael Asif, Arif Hossain, Mohammad J Med Cases Case Report Paget-Schroetter syndrome (PSS) is a primary upper extremity deep vein thrombosis (DVT) that occurs with no significant risk factors, mostly in a young and healthy patient. Treatment of this disease is discussed heavily in the literature and the optimal treatment method is still being debated. Here, we present a patient with PSS treated with balloon angioplasty, thrombolysis and treatment with an oral thrombin inhibitor (apixaban) who developed recurrence of PSS. A 38-year-old white male with no past medical history, presented to an urgent care center with sudden onset axillary pain and an axillary lump that was treated with outpatient antibiotics. Extensive deep venous thrombosis was diagnosed with computed tomography (CT) and ultrasound. He underwent percutaneous pharmacomechanical thrombectomy. Postprocedural angiogram showed significant improvement in the caliber of the axillary and subclavian veins where they crossed the first rib. He was discharged on apixaban and underwent removal of his first rib 1 month later. He returned 3 weeks later with recurrence of right arm pain and swelling. Repeat ultrasound showed thrombus in the right arm and venogram confirmed 80% stenosis at the subclavian vein as it enters the innominate vein. He was again treated with placement of a thrombolytic catheter and overnight thrombolysis of the central venous circulation on the right-side upper extremity balloon angioplasty of the subclavian vein, axillary vein, and basilic vein. He is disease-free for 6 months. Recurrence of PSS after surgical removal of rib, thrombectomy, thrombolysis while using apixaban is very rare. This is the first case to our knowledge presented with recurrent PSS treated with apixaban, early rib resection, balloon angioplasty and thrombectomy. Elmer Press 2020-01 2020-01-31 /pmc/articles/PMC8383678/ /pubmed/34434331 http://dx.doi.org/10.14740/jmc3416 Text en Copyright 2020, Akoluk et al. https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Akoluk, Arda
Douedi, Steven
Dattadeen, Jaraad
Patel, Ishan
Mushtaq, Arman
Levitt, Michael
Asif, Arif
Hossain, Mohammad
Recurrence of Paget-Schroetter Syndrome: A Rare Case Report and Review of Literature
title Recurrence of Paget-Schroetter Syndrome: A Rare Case Report and Review of Literature
title_full Recurrence of Paget-Schroetter Syndrome: A Rare Case Report and Review of Literature
title_fullStr Recurrence of Paget-Schroetter Syndrome: A Rare Case Report and Review of Literature
title_full_unstemmed Recurrence of Paget-Schroetter Syndrome: A Rare Case Report and Review of Literature
title_short Recurrence of Paget-Schroetter Syndrome: A Rare Case Report and Review of Literature
title_sort recurrence of paget-schroetter syndrome: a rare case report and review of literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383678/
https://www.ncbi.nlm.nih.gov/pubmed/34434331
http://dx.doi.org/10.14740/jmc3416
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