Arterialized venous flap

ABSTRACT

Paget-Schroetter syndrome is synonymous with spontaneous or effort-induced thrombosis of the axillosubclavian vein that is characterized by swelling and pain on upper extremity. Though axillosubclavian thrombosis represents only 1 - 2%, its frequency of diagnosis has increased over the past years due to improvement of ultrasonography. Although the cause of catheter and drug-related cases is clear, several studies have invested the etiology of Paget- Schroetter syndrome, a condition more commonly seen in the young and otherwise healthy individual. Factors often cited include compression of the vein by the anatomic structure, stress, or excessive effort to the extremity, and repetitive shoulder-arm motion. In the view of treatment, thrombolysis by direct infusion of urokinase has proven to be superior to surgical thrombectomy and is now treatment of choice. We successfully treated a 30-year-old man who suffered from swelling and pain on the right upper extremity by using direct urokinase infusion on thrombosis of subclavian vein. This is very rare disease in plastic and reconstructive surgery, thus diagnosis will seldom be made on clinical evaluation. It should be included in the differential diagnosis of upper extremity swelling compared with lymphedema.