Modern approaches in the treatment of patients with Paget-Schretter syndrome

Goal. Consider the management of patients with effort thrombosis (Paget-Schretter syndrome).The article presents the modern vision of the problem of effort thrombosis. This review is aimed at describing the epidemiology, pathophysiology, diagnosis and treatment of patients with Paget-Schretter syndr...

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Main Authors: I. N. Sonkin, L. I. Syromyatnikova, E. Kh. Alieva, S. A. Mehryakov
Format: Article
Language:Russian
Published: InterMedservice 2021-11-01
Series:Евразийский Кардиологический Журнал
Subjects:
Online Access:https://www.heartj.asia/jour/article/view/6291
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author I. N. Sonkin
L. I. Syromyatnikova
E. Kh. Alieva
S. A. Mehryakov
author_facet I. N. Sonkin
L. I. Syromyatnikova
E. Kh. Alieva
S. A. Mehryakov
author_sort I. N. Sonkin
collection DOAJ
description Goal. Consider the management of patients with effort thrombosis (Paget-Schretter syndrome).The article presents the modern vision of the problem of effort thrombosis. This review is aimed at describing the epidemiology, pathophysiology, diagnosis and treatment of patients with Paget-Schretter syndrome. SPS occurs spontaneously, as a rule, in young, healthy and active patients aged 20-30 years after strenuous physical activity. The ratio of men and women is 2:1, recently there has been a growing trend among women. The main complaints of patients with SPS include swelling of the affected limb, discomfort when moving the affected arm, pain and heaviness when trying to raise the arm up. When examining these patients, attention is paid to hyperemia of the skin or their cyanotic nature, pasty limbs, as well as an enhanced venous pattern on the shoulder, the so-called Arshel sign. The diagnosis is based on the data of anamnesis, physical examination, the “gold standard of diagnostics” – ultrasound examination of veins, the sensitivity and specificity of which is 70-100%. The first step in the diagnosis can be the evaluation of the D-dimer, with its negative values, the SPSH is rejected. With an obvious clinic and controversial results of serial ultrasound examinations, other imaging methods are used, such as computed contrast tomography, magnetic resonance imaging, the diagnostic value of which is especially significant in occlusive venous thrombosis.SPS differs not only from DVT of the lower extremities, but also from secondary DVT of the upper extremities, which determines the peculiarities of management of this category of patients, including surgical treatment aimed at preventing subclavian vein compression in the future. The article summarizes the experience in the management of patients with blood thrombosis.
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spelling doaj.art-40e6a88ceb884153a565f49e568fe9e72023-03-13T07:47:39ZrusInterMedserviceЕвразийский Кардиологический Журнал2225-16852305-07482021-11-0104687210.38109/2225-1685-2021-4-68-726250Modern approaches in the treatment of patients with Paget-Schretter syndromeI. N. Sonkin0L. I. Syromyatnikova1E. Kh. Alieva2S. A. Mehryakov3ЧУЗ «Клиническая больница «РЖД-Медицина» города Санкт-Петербург»Федеральное государственное бюджетное образовательное учреждение высшего образования «Пермский государственный медицинский университет имени академика Е.А. Вагнера» Минздрава России; Государственное автономное учреждение здравоохранения Пермского края «Городская клиническая больница №4»Федеральное государственное бюджетное образовательное учреждение высшего образования «Пермский государственный медицинский университет имени академика Е.А. Вагнера» Минздрава России; ГБУЗ ПК «Клинический кардиологический диспансер»Государственное автономное учреждение здравоохранения Пермского края «Городская клиническая больница №4»Goal. Consider the management of patients with effort thrombosis (Paget-Schretter syndrome).The article presents the modern vision of the problem of effort thrombosis. This review is aimed at describing the epidemiology, pathophysiology, diagnosis and treatment of patients with Paget-Schretter syndrome. SPS occurs spontaneously, as a rule, in young, healthy and active patients aged 20-30 years after strenuous physical activity. The ratio of men and women is 2:1, recently there has been a growing trend among women. The main complaints of patients with SPS include swelling of the affected limb, discomfort when moving the affected arm, pain and heaviness when trying to raise the arm up. When examining these patients, attention is paid to hyperemia of the skin or their cyanotic nature, pasty limbs, as well as an enhanced venous pattern on the shoulder, the so-called Arshel sign. The diagnosis is based on the data of anamnesis, physical examination, the “gold standard of diagnostics” – ultrasound examination of veins, the sensitivity and specificity of which is 70-100%. The first step in the diagnosis can be the evaluation of the D-dimer, with its negative values, the SPSH is rejected. With an obvious clinic and controversial results of serial ultrasound examinations, other imaging methods are used, such as computed contrast tomography, magnetic resonance imaging, the diagnostic value of which is especially significant in occlusive venous thrombosis.SPS differs not only from DVT of the lower extremities, but also from secondary DVT of the upper extremities, which determines the peculiarities of management of this category of patients, including surgical treatment aimed at preventing subclavian vein compression in the future. The article summarizes the experience in the management of patients with blood thrombosis.https://www.heartj.asia/jour/article/view/6291синдром педжета-шреттератромбоз глубоких вен
spellingShingle I. N. Sonkin
L. I. Syromyatnikova
E. Kh. Alieva
S. A. Mehryakov
Modern approaches in the treatment of patients with Paget-Schretter syndrome
Евразийский Кардиологический Журнал
синдром педжета-шреттера
тромбоз глубоких вен
title Modern approaches in the treatment of patients with Paget-Schretter syndrome
title_full Modern approaches in the treatment of patients with Paget-Schretter syndrome
title_fullStr Modern approaches in the treatment of patients with Paget-Schretter syndrome
title_full_unstemmed Modern approaches in the treatment of patients with Paget-Schretter syndrome
title_short Modern approaches in the treatment of patients with Paget-Schretter syndrome
title_sort modern approaches in the treatment of patients with paget schretter syndrome
topic синдром педжета-шреттера
тромбоз глубоких вен
url https://www.heartj.asia/jour/article/view/6291
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AT ekhalieva modernapproachesinthetreatmentofpatientswithpagetschrettersyndrome
AT samehryakov modernapproachesinthetreatmentofpatientswithpagetschrettersyndrome