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Online ISSN 1827-1847
Urschel, H. C., Jr.
Baylor University Medical Center, Dallas, TX, USA
In Paget-Schroetter syndrome, recognition that a congenitally lateral insertion of the costoclavicular ligament on the first rib causes venous occlusion and the earlier the diagnosis and treatment, the better the results (less than six weeks seems to give excellent results, whereas longer intervals are not quite as good). Early venogram with thrombolytic agents to open the thrombosed axillary subclavian vein is the preferred treatment. Prompt transaxillary first rib resection and neurovascular decompression, particularly in the area of the axillary subclavian venous canal, should be expedited. Anticoagulants did not appear helpful after this procedure.