CASE REPORT article
Front. Surg.
Sec. Vascular Surgery
Subacute Paget-Schroetter with Rapid Recurrence and Concurrent Pulmonary Emboli: A Case Report
Provisionally accepted
- 1Nova Southeastern University, Fort Lauderdale, United States
- 2Lakeland Regional Medical Center, Lakeland, United States
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Effort thrombosis, also known as Paget-Schroetter Syndrome, is a rare venous manifestation of Thoracic Outlet Syndrome, primarily affecting young adults who perform repetitive overhead motions, such as athletes and trades workers. Stasis occurs when surrounding tissues encroach upon venous flow through the subclavian and/or axillary veins, manifesting as pain, swelling, and discoloration, with a potential for pulmonary embolism and other sequelae if left untreated. We present a 22-year-old male, avid weightlifter, with initial and recurrent left subclavian thrombosis and right pulmonary emboli, who did not respond to mechanical thrombectomy and anticoagulation, requiring surgical reconstruction at the thoracic outlet only two weeks after initial presentation. While there are no consensus guidelines for the management of Paget-Schroetter syndrome, aggressive management of acute thrombi demonstrates low rates of recurrence. There is less guidance regarding subacute thrombi. We advocate for a similarly aggressive approach to management of subacute thrombi to prevent recurrence and complications such as pulmonary embolism, post-thrombotic syndrome, and vessel fibrosis.
Keywords: Paget-Schroetter, Pulmonary embolus, effort thrombosis, case report, Thrombectomy, first rib resection and scalenectomy, Catheter directed thrombolysis (CDT)
Received: 15 Sep 2025; Accepted: 14 Oct 2025.
Copyright: © 2025 O'Toole, Kemp Van Ee, Madison, DiVincenzo, Tran and Mohamed. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shantele Kemp Van Ee, shantele.kempvanee@mylrh.org
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