Upper extremity venous occlusion

Upper extremity venous occlusion describes a condition in which the vein coming from the arm into the chest becomes narrowed, blocked or pinched. It is usually seen in people who use their arms in repetitive tasks, such as swimming or house painting. The overuse of the muscles results in thickening that can pinch the vein where it enters the body from the arm, just above the first rib.

Reduced flow of blood from the arm is usually acute, causing pain, swelling, or discoloration of the arm. It requires immediate medical attention to restore proper blood-flow.

The condition is known by several names, including: Paget-von Schröetter Syndrome, upper extremity deep vein thrombosis (DVT), axillo-subclavian vein thrombosis and effort thrombosis. It mostly occurs in young people.

People who perform heavy, repetitive tasks involving the arms are most at risk for developing upper extremity venous occlusion. It is more common in young people, from teens to those in their 40s. However, the elderly can develop upper extremity venous occlusion as a complication of medical procedures, such as the use of cardiac pacemakers.

Upper extremity venous occlusion usually presents in the sudden onset of swelling, discomfort, aching or heaviness of the arm. Sometimes, the arm may take on a bluish discoloration.

The treatment of upper extremity venous occlusion is aimed at opening the occluded vein segment and keeping it open. Anti-clotting medication (anticoagulants) is almost always be used to keep the clot from progressing and recurring. If the blockage is acute, medication may be used to dissolve the clot (thrombolytics). Once the vein has been opened, additional treatment may be beneficial. Treatment might include removal of the first rib and possible balloon angioplasty of the vein. A hospital stay of three to 76 days and a recovery time of two to eight weeks is expected.