Fig. 2.

Extensive upper extremity deep vein thrombosis requiring mechanical thrombectomy and balloon angioplasty in a 31-year-old man with axillo-subclavian thrombosis secondary to Paget-Schroetter syndrome. (a) Digital subtraction venogram showing significant thrombus in the right axillary and subclavian veins (solid black arrows) with no appreciable contrast reaching the superior vena cava. Further examination (not shown) demonstrated a patent superior vena cava. (b) Thrombolysis catheter placement spanning the entire extent of the thrombus (white arrows). (c) Venogram obtained following 24 hours of thrombolytic infusion demonstrates persistent axillo-subclavian thrombosis. (d) Mechanical thrombectomy resulted in reduction in thrombus burden, but significant residual stenosis is noted at the site of subclavian vein compression by the first rib (black arrowhead). (e) Prolonged angioplasty was performed at the site of the stenosis (white arrowheads). (f) Residual extrinsic compression remained (dashed black arrow), and the patient was placed on anticoagulation and then underwent first-rib resection 5 days later.