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Case Reports in Vascular Medicine
Volume 2017 (2017), Article ID 8764903, 4 pages
https://doi.org/10.1155/2017/8764903
Case Report

Recurrent Upper Extremity Thrombosis Associated with Overactivity: A Case of Delayed Diagnosis of Paget-Schroetter Syndrome

Department of Internal Medicine, University of Toledo Medical Center, Toledo, OH, USA

Correspondence should be addressed to Himani Sharma; moc.liamg@700inamih

Received 26 March 2017; Revised 23 May 2017; Accepted 13 June 2017; Published 10 July 2017

Academic Editor: Halvor Naess

Copyright © 2017 Himani Sharma and Abhinav Tiwari. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Paget-Schroetter syndrome is thrombosis of the axillary-subclavian vein that is associated with strenuous and repetitive activity of the upper extremities. Overuse of the arm coupled with external compression results in microtrauma in the intima of the subclavian vein, resulting in the activation of the coagulation cascade. Diagnosis is usually made by Doppler ultrasound and the treatment involves thrombolysis, while routine surgical decompression of the thoracic outlet is controversial. In this report, we present a case of a patient who presented with a second episode of spontaneous right upper extremity deep venous thrombosis. The first episode was inadequately treated with oral anticoagulation alone. During the second episode, Paget-Schroetter syndrome was diagnosed, after careful review of his occupational history. He subsequently underwent angioplasty and decompression of thoracic outlet with no recurrence of thrombosis in a 12-month follow-up period.