Paget-Schroetter disease natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Anahita Deylamsalehi, M.D.[2]
Overview
The symptoms of Paget-Schroetter syndrome usually develop in the forth decade of life. Common complications include pulmonary embolism, recurrent thrombosis, superior vena cava syndrome and sepsis. Patients with early diagnosis and proper treatments usually have good prognosis.
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Natural History, Complications, and Prognosis
Natural History
- The symptoms of Paget-Schroetter syndrome usually develop in the forth decade of life, and start with symptoms such as shoulder and upper extremity pain and swelling.
- If left untreated, up to 78% of patients with Paget-Schroetter disease may progress to develop residual upper extremity venous obstruction, also continuous symptoms and permanent disability is expected in 41% to 91% and 39% to 68% of untreated patients, respectively.[1]
Complications
- Common complications of Paget-Schroetter disease include:
- Pulmonary embolism
- Post-thrombotic syndrome[2]
- Recurrent thrombosis
- Signs and symptoms of superior vena cava syndrome
- Venous gangrene of upper extremity
- Signs and symptoms of systemic sepsis secondary to infection of thrombus
Prognosis
- Patients with early diagnosis and proper treatments usually have good prognosis.[3]
- Up to 90% of patients who received thrombolysis in combination with thoracic outlet decompression surgery experienced desirable outcomes.[4]
- Without prompt and proper treatment Paget-Schroetter disease is associated with high morbidity.[5]
- Immediate surgical intervention is related with better prognosis.[6]
References
- ↑ Illig, Karl A.; Doyle, Adam J. (2010). "A comprehensive review of Paget-Schroetter syndrome". Journal of Vascular Surgery. 51 (6): 1538–1547. doi:10.1016/j.jvs.2009.12.022. ISSN 0741-5214.
- ↑ 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.
- ↑ Ibrahim, Ramy; Dashkova, Irina; Williams, Myia; Kozikowski, Andrzej; Abrol, Neeraj; Gandhi, Anjula; Pekmezaris, Renee (2017). "Paget-Schroetter syndrome in the absence of common predisposing factors: a case report". Thrombosis Journal. 15 (1). doi:10.1186/s12959-017-0146-0. ISSN 1477-9560.
- ↑ "StatPearls". 2020. PMID 29494023.
- ↑ DeLisa LC, Hensley CP, Jackson S (2017). "Diagnosis of Paget-Schroetter Syndrome/Primary Effort Thrombosis in a Recreational Weight Lifter". Phys Ther. 97 (1): 13–19. doi:10.2522/ptj.20150692. PMID 27587803.
- ↑ DeLisa LC, Hensley CP, Jackson S (2017). "Diagnosis of Paget-Schroetter Syndrome/Primary Effort Thrombosis in a Recreational Weight Lifter". Phys Ther. 97 (1): 13–19. doi:10.2522/ptj.20150692. PMID 27587803.