Paget-Schroetter disease historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]

Overview

Spontaneous axillary-subclavian vein thrombosis (ASVT) has been first described by Cruveilhier. Sir James Paget identified the subclavian vein thrombosis in one of his patients. Hughes created the term "Paget-Schroetter".

Historical Perspective

Discovery

  • Spontaneous axillary-subclavian vein thrombosis (ASVT) has been first described by Cruveilhier in 1816.[1]
  • In 1875, Sir James Paget identified the subclavian vein thrombosis in one of his patients. [2]
  • Von Schroetter was the first one who hypothesized the relation between vascular injury from muscle strain and subclavian vein thrombosis in 1894. [3]
  • In 1949 Hughes created the term "Paget-Schroetter" and published the first review.[4]
  • The father of a patient used google to diagnose his son's Paget-Von Schrötter syndrome by querying on the symptoms, and it resulted in one of the first descriptions of "googling for diagnosis".[5]

Landmark Events in the Development of Treatment Strategies

  • Lee et al. used a treatment approach started with catheter-directed thrombolysis.
  • J. Ernesto Molina, MD, a vascular surgeon at the University of Minnesota, has expressed the following opinion:[6]
    1. "The currently acceptable treatment for that condition is lytic therapy followed by surgery. The patients were followed up to investigate the rate of recurrence. However, if surgery is not done, the problem will invariably recur. If patients are treated with only anticoagulants and even thrombolytics but no surgery, I expect the recurrence rate to be high."
    2. "Most patients who suffer this condition do not have any abnormality in their coagulation mechanism" and in fact suffer from "A direct injury to the endothelium,"
    3. "Treatment for Paget-Schroetter syndrome entails the use of thrombolytics followed by surgery to decompress the thoracic inlet and widening of the vein, usually with a vein patch."
  • Molina et al. reported 5 years of 100% vein patency and complete symptom resolution in patients who treated with thrombolysis and first rib resection.[7]

References

  1. Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK (2010). "Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis". West J Emerg Med. 11 (4): 358–62. PMC 2967689. PMID 21079709.
  2. Sheth, Deepa; Ferral, Hector; Patel, Nilesh H. (2007). "AJR Teaching File: Weight Lifter with Swelling in the Upper Arm". American Journal of Roentgenology. 189 (3_supplement): S21–S23. doi:10.2214/AJR.06.0983. ISSN 0361-803X.
  3. Sheth, Deepa; Ferral, Hector; Patel, Nilesh H. (2007). "AJR Teaching File: Weight Lifter with Swelling in the Upper Arm". American Journal of Roentgenology. 189 (3_supplement): S21–S23. doi:10.2214/AJR.06.0983. ISSN 0361-803X.
  4. HUGHES ES (1949). "Venous obstruction in the upper extremity; Paget-Schroetter's syndrome; a review of 320 cases". Surg Gynecol Obstet. 88 (2): 89–127. PMID 18108679.
  5. Hangwi Tang & Jennifer Hwee Kwoon Ng (2006). "Googling for a diagnosis—use of Google as a diagnostic aid: internet based study". BMJ. 333: 1143–1145. doi:10.1136/bmj.39003.640567.AE. Unknown parameter |month= ignored (help)
  6. "Letter Regarding Article by Martinelli et al, "Risk Factors and Recurrence Rate of Primary Deep Vein Thrombosis of the Upper Extremities" * Response -- Molina et al. 111 (9): e118 -- Circulation". Retrieved 2007-07-02.
  7. Molina, J. Ernesto; Hunter, David W.; Dietz, Charles A. (2007). "Paget-Schroetter syndrome treated with thrombolytics and immediate surgery". Journal of Vascular Surgery. 45 (2): 328–334. doi:10.1016/j.jvs.2006.09.052. ISSN 0741-5214.

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