Paget-Schroetter syndrome: A contemporary review of the controversies in management.

Abstract:

AIM:To assess the current evidence, controversies and technologies behind the various approaches and steps in the management of Paget-Schroetter syndrome. MATERIALS AND METHODS:We performed a narrative review based on a literature search in Embase, Medline, Pubmed and Google Scholar through keyword searching related to upper extremity deep vein thrombosis, Paget-Schroetter syndrome and venous thoracic outlet syndrome. RESULTS:There is a paucity of high-quality evidence assessing the efficacy of contemporary approaches for the management of acute upper extremity deep vein thrombosis which, though promising, is largely limited to single institution case studies and small series. As a result, a formal systematic review could not be performed. CONCLUSIONS:Paget-Schroetter syndrome is a rare condition, whose management approaches are largely guided by the accumulated expertise and clinical experience of vascular specialists. In the absence of randomized controlled trials, current practice has been guided by retrospective reviews and experience. Modern approaches and protocols appear to remain distinct between health care facilities, but have common features including early clot lysis, surgical decompression with first rib resection, followed by adjunctive open or endovascular procedures. Further high-quality level 1 evidence and research are required in order to standardize treatment for this condition.

journal_name

Phlebology

journal_title

Phlebology

authors

Cai TY,Rajendran S,Saha P,Dubenec S

doi

10.1177/0268355519898920

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

461-471

issue

7

eissn

0268-3555

issn

1758-1125

journal_volume

35

pub_type

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