Paget-von Schroetter Syndrome eter-directed subclavian vein thrombolysis, balloon angio- plasty, stent placement, paraclavicular thoracic outlet de- compression, saphenous vein patch angioplasty, reversed saphenous vein graft bypass, rib resection, scalenectomy, resection of the clavicular callus, and axillo-jugular bypass. Aggressive endovascular treatment is also effective [1, 2, 6, 7, 9, 10]. In our case, surgical treatment was not deemed to be appropriate as the patient had already developed exten- sive venous collaterals. In conclusion, PSS should be considered in the differ- ential diagnosis of effort induced upper extremity pain and swelling. Conservative non-operative treatment is accept- able and can be successfully used with favorable long-term outcomes. References 1. Shebel ND, Marin A. Effort thrombosis (Paget-Schroet- ter syndrome) in active young adults: current concepts in diagnosis and treatment. J Vasc Nurs 2006;24(4):116- 126. 2. Feugier P, Chevalier JM. The Paget-Schroetter syn- drome. Acta Chir Belg 2005;105(3):256-264. 3. Doyle A, Wolford HY, Davies MG, Adams JT, Singh MJ, Saad WE, Waldman DL, et al. Management of effort J Clin Med Res • 2009;1(3):178-180 thrombosis of the subclavian vein: today’s treatment. Ann Vasc Surg 2007;21(6):723-729. 4. Haire WD. Arm vein thrombosis. Clin Chest Med 1995;16(2):341-351. 5. Rutherford RB. Primary subclavian-axillary vein throm- bosis: the relative roles of thrombolysis, percutane- ous angioplasty, stents, and surgery. Semin Vasc Surg 1998;11(2):91-95. 6. Caparrelli DJ, Freischlag J. A unified approach to axil- losubclavian venous thrombosis in a single hospital ad- mission. Semin Vasc Surg 2005;18(3):153-157. 7. Landry GJ, Liem TK. Endovascular management of Paget-Schroetter syndrome. Vascular 2007;15(5):290- 296. 8. Krishna K, Shah A, Garg A, Pathan S. Paget-Schroetter syndrome. J Assoc Physicians India 2007;55(371-373. 9. Melby SJ, Vedantham S, Narra VR, Paletta GA, Jr., Khoo-Summers L, Driskill M, Thompson RW. Compre- hensive surgical management of the competitive athlete with effort thrombosis of the subclavian vein (Paget- Schroetter syndrome). J Vasc Surg 2008;47(4):809-820; discussion 821. 10. Feugier P, Aleksic I, Salari R, Durand X, Chevalier JM. Long-term results of venous revascularization for Paget-Schroetter syndrome in athletes. Ann Vasc Surg 2001;15(2):212-218. 180 Articles © The authors, Journal compilation © J Clin Med Res and Elmer Press™, www.jocmr.org