Claviculectomy With Thrombectomy for Management of Paget-Schroetter Syndrome in a Patient With Chronic Clavicular Malunion

Paget-Schroetter syndrome, or primary upper extremity deep vein thrombosis, is a relatively rare condition for which various treatment protocols have been proposed. No randomized controlled trials exist to guide management, and treatment must be tailored to the individual. This report describes a case of a 39-year-old man with chronic clavicular malunion from multiple clavicular fractures who presented with Paget-Schroetter syndrome. The thrombus occluded the right axillary, brachial, and subclavian veins. Attempted thrombolytic therapy was unsuccessful, and decompressive surgery was used to avoid postphlebitic complications and regain functionality of the upper extremity. Rather than first rib resection, claviculectomy with thrombectomy and subclavian vein repair was performed.