Paget Schroetter syndrome imaged in multiple modalities and successfully treated with pharmacomechanical thrombectomy

Description

A young man in his early 30s presented with a 3-day history of left upper arm swelling and erythema (figure 1). He had no significant medical history. Of note he had a strong family history of deep venous thrombosis (DVT) with both parents having had lower limb DVTs. D-dimers were elevated, and the remaining laboratory investigations were within normal limits.

Figure 1

Erythematous, oedematous left upper limb.

An upper limb Doppler ultrasound scan showed occlusive thrombus in the left subclavian vein (figure 2). A CT venogram further delineated the extent of the thrombus confirming the diagnosis of Paget Schroetter syndrome (figures 3 and 4). Subsequently, a conventional venogram was performed in conjunction with a therapeutic pharmacomechanical thrombectomy, which successfully restored flow in the left subclavian vein (figures 5 and 6).

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