Paget-Schroetter disease CT: Difference between revisions

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{{Paget-Schroetter disease}}
{{Paget-Schroetter disease}}
{{CMG}}; {{AE}}
{{CMG}}; {{AE}} {{Anahita}}


== Overview ==
== Overview ==
[[Computed tomography]] (CT) is useful in the presence of atypical symptoms or in the setting of a normal [[ultrasound]] in a highly suspected patient.<ref name="HanggeRotellini-Coltvet2017">{{cite journal|last1=Hangge|first1=Patrick|last2=Rotellini-Coltvet|first2=Lisa |last3=Deipolyi|first3=Amy R. |last4=Albadawi|first4=Hassan |last5=Oklu|first5=Rahmi |title=Paget-Schroetter syndrome: treatment of venous thrombosis and outcomes|journal=Cardiovascular Diagnosis and Therapy|volume=7|issue=S3|year=2017|pages=S285–S290|issn=22233652|doi=10.21037/cdt.2017.08.15}}</ref>
[[Computed tomography]] (CT) is useful in the presence of atypical symptoms or in the setting of a normal [[ultrasound]] in a highly suspected patient.


== CT ==
== CT ==


* [[Computed tomography]] (CT) is helpful to confirm or exclude the diagnosis whenever [[Paget-Schroetter disease]] is highly suspected, but there are no abnormal ultrasound findings. This imaging method could also be used to study other possible etiologies of [[Subclavian]]-[[Axillary vein]] compression.<ref name="Rosa SalazarOtálora Valderrama2015">{{cite journal|last1=Rosa Salazar|first1=Vladimir|last2=Otálora Valderrama|first2=Sonia del Pilar|last3=Hernández Contreras|first3=María Encarnación|last4=García Pérez|first4=Bartolomé|last5=Arroyo Tristán|first5=Andrés del Amor|last6=García Méndez|first6=María del Mar|title=Multidisciplinary Management of Paget-Schroetter Syndrome. A Case Series of Eight Patients|journal=Archivos de Bronconeumología (English Edition)|volume=51|issue=8|year=2015|pages=e41–e43|issn=15792129|doi=10.1016/j.arbr.2015.05.026}}</ref>
* [[Computed tomography]] (CT) is helpful to confirm or exclude the diagnosis whenever [[Paget-Schroetter disease]] is highly suspected, but there are no abnormal ultrasound findings. CT imaging method could also be used to study other possible etiologies of [[Subclavian]]-[[Axillary vein]] compression.<ref name="Rosa SalazarOtálora Valderrama2015">{{cite journal|last1=Rosa Salazar|first1=Vladimir|last2=Otálora Valderrama|first2=Sonia del Pilar|last3=Hernández Contreras|first3=María Encarnación|last4=García Pérez|first4=Bartolomé|last5=Arroyo Tristán|first5=Andrés del Amor|last6=García Méndez|first6=María del Mar|title=Multidisciplinary Management of Paget-Schroetter Syndrome. A Case Series of Eight Patients|journal=Archivos de Bronconeumología (English Edition)|volume=51|issue=8|year=2015|pages=e41–e43|issn=15792129|doi=10.1016/j.arbr.2015.05.026}}</ref><ref name="HanggeRotellini-Coltvet2017">{{cite journal|last1=Hangge|first1=Patrick|last2=Rotellini-Coltvet|first2=Lisa |last3=Deipolyi|first3=Amy R. |last4=Albadawi|first4=Hassan |last5=Oklu|first5=Rahmi |title=Paget-Schroetter syndrome: treatment of venous thrombosis and outcomes|journal=Cardiovascular Diagnosis and Therapy|volume=7|issue=S3|year=2017|pages=S285–S290|issn=22233652|doi=10.21037/cdt.2017.08.15}}</ref>
* [[CT angiography]] is an accurate diagnostic tool capable of detecting valuable findings suggestive of [[Paget-Schroetter disease]]. Such as:
* [[CT angiography]] is an accurate diagnostic tool capable of detecting valuable findings suggestive of [[Paget-Schroetter disease]], such as:
**[[Axillary vein|Axillary]]-[[Subclavian vein]] occlusion
**[[Axillary vein|Axillary]]-[[Subclavian vein]] occlusion
** Point stenosis of Axillary-Subclavian vein at level of the [[first rib]]<ref name="Thompson20122">{{cite journal|last1=Thompson|first1=Robert|title=Comprehensive Management of Subclavian Vein Effort Thrombosis|journal=Seminars in Interventional Radiology|volume=29|issue=01|year=2012|pages=044–051|issn=0739-9529|doi=10.1055/s-0032-1302451}}</ref>
** Point stenosis of Axillary-Subclavian vein at level of the [[first rib]]<ref name="Thompson20122">{{cite journal|last1=Thompson|first1=Robert|title=Comprehensive Management of Subclavian Vein Effort Thrombosis|journal=Seminars in Interventional Radiology|volume=29|issue=01|year=2012|pages=044–051|issn=0739-9529|doi=10.1055/s-0032-1302451}}</ref>
** Determining the presence of dilated collateral veins<ref name="Thompson2012">{{cite journal|last1=Thompson|first1=Robert|title=Comprehensive Management of Subclavian Vein Effort Thrombosis|journal=Seminars in Interventional Radiology|volume=29|issue=01|year=2012|pages=044–051|issn=0739-9529|doi=10.1055/s-0032-1302451}}</ref>
** Determining the presence of dilated collateral veins<ref name="Thompson2012">{{cite journal|last1=Thompson|first1=Robert|title=Comprehensive Management of Subclavian Vein Effort Thrombosis|journal=Seminars in Interventional Radiology|volume=29|issue=01|year=2012|pages=044–051|issn=0739-9529|doi=10.1055/s-0032-1302451}}</ref>
** Positional [[subclavian vein]] obstruction (when performed at rest with elevated [[upper limb]])<ref name="Thompson20123">{{cite journal|last1=Thompson|first1=Robert|title=Comprehensive Management of Subclavian Vein Effort Thrombosis|journal=Seminars in Interventional Radiology|volume=29|issue=01|year=2012|pages=044–051|issn=0739-9529|doi=10.1055/s-0032-1302451}}</ref>
** Positional [[subclavian vein]] obstruction (when performed at rest with elevated [[upper limb]])<ref name="Thompson20123">{{cite journal|last1=Thompson|first1=Robert|title=Comprehensive Management of Subclavian Vein Effort Thrombosis|journal=Seminars in Interventional Radiology|volume=29|issue=01|year=2012|pages=044–051|issn=0739-9529|doi=10.1055/s-0032-1302451}}</ref>
* [[Computed tomography|CT venography]] can detect [[thrombus]] in venous system.<ref name="pmid29494023">{{cite journal| author=| title=StatPearls | journal= | year= 2020 | volume=  | issue=  | pages=  | pmid=29494023 | doi= | pmc= | url= }}</ref> It is associated with [[Radiocontrast|radio contrast]] related side effects.<ref name="pmid21079709">{{cite journal| author=Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK| title=Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis. | journal=West J Emerg Med | year= 2010 | volume= 11 | issue= 4 | pages= 358-62 | pmid=21079709 | doi= | pmc=2967689 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21079709  }}</ref>
* [[Computed tomography|CT venography]] can detect [[thrombus]] in venous system.<ref name="pmid29494023">{{cite journal| author=| title=StatPearls | journal= | year= 2020 | volume=  | issue=  | pages=  | pmid=29494023 | doi= | pmc= | url= }}</ref>  
*[[Computed tomography|CT venography]] is associated with [[Radiocontrast|radio contrast]] related side effects.<ref name="pmid21079709">{{cite journal| author=Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK| title=Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis. | journal=West J Emerg Med | year= 2010 | volume= 11 | issue= 4 | pages= 358-62 | pmid=21079709 | doi= | pmc=2967689 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21079709  }}</ref>


[[File: Subclavian and Axillary vein occlusion.jpg|alt=Subclavian and Axillary vein occlusion on CT angiogram|center|thumb|472x472px|Computed tomography angiogram chest reveal a thrombosis of the right subclavian and axillary veins with a subtle filling defect at the junction of the right subclavian, jugular and brachiocephalic veins (red arrow). Case courtesy by Jesse Kellar, MD<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100831/|title=Thoracic Outlet Syndrome with Secondary Paget Schröetter Syndrome: A Rare Case of Effort-Induced Thrombosis of the Upper Extremity|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>]]
[[File: Subclavian and Axillary vein occlusion.jpg|alt=Subclavian and Axillary vein occlusion on CT angiogram|center|thumb|472x472px|Computed tomography angiogram chest reveal a thrombosis of the right subclavian and axillary veins with a subtle filling defect at the junction of the right subclavian, jugular and brachiocephalic veins (red arrow). Case courtesy by Jesse Kellar, MD<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100831/|title=Thoracic Outlet Syndrome with Secondary Paget Schröetter Syndrome: A Rare Case of Effort-Induced Thrombosis of the Upper Extremity|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>]]

Latest revision as of 20:18, 23 June 2020

Paget-Schroetter disease Microchapters

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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

Computed tomography (CT) is useful in the presence of atypical symptoms or in the setting of a normal ultrasound in a highly suspected patient.

CT

Subclavian and Axillary vein occlusion on CT angiogram
Computed tomography angiogram chest reveal a thrombosis of the right subclavian and axillary veins with a subtle filling defect at the junction of the right subclavian, jugular and brachiocephalic veins (red arrow). Case courtesy by Jesse Kellar, MD[8]

References

  1. ↑ Rosa Salazar, Vladimir; Otálora Valderrama, Sonia del Pilar; Hernández Contreras, María Encarnación; García Pérez, Bartolomé; Arroyo Tristán, Andrés del Amor; García Méndez, María del Mar (2015). "Multidisciplinary Management of Paget-Schroetter Syndrome. A Case Series of Eight Patients". Archivos de Bronconeumología (English Edition). 51 (8): e41–e43. doi:10.1016/j.arbr.2015.05.026. ISSN 1579-2129.
  2. ↑ Hangge, Patrick; Rotellini-Coltvet, Lisa; Deipolyi, Amy R.; Albadawi, Hassan; Oklu, Rahmi (2017). "Paget-Schroetter syndrome: treatment of venous thrombosis and outcomes". Cardiovascular Diagnosis and Therapy. 7 (S3): S285–S290. doi:10.21037/cdt.2017.08.15. ISSN 2223-3652.
  3. ↑ Thompson, Robert (2012). "Comprehensive Management of Subclavian Vein Effort Thrombosis". Seminars in Interventional Radiology. 29 (01): 044–051. doi:10.1055/s-0032-1302451. ISSN 0739-9529.
  4. ↑ Thompson, Robert (2012). "Comprehensive Management of Subclavian Vein Effort Thrombosis". Seminars in Interventional Radiology. 29 (01): 044–051. doi:10.1055/s-0032-1302451. ISSN 0739-9529.
  5. ↑ Thompson, Robert (2012). "Comprehensive Management of Subclavian Vein Effort Thrombosis". Seminars in Interventional Radiology. 29 (01): 044–051. doi:10.1055/s-0032-1302451. ISSN 0739-9529.
  6. ↑ "StatPearls". 2020. PMID 29494023.
  7. ↑ 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.
  8. ↑ "Thoracic Outlet Syndrome with Secondary Paget Schröetter Syndrome: A Rare Case of Effort-Induced Thrombosis of the Upper Extremity".

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