Management of Paget-Schroetter: a Systematic Review and Meta-Analysis

Objective: Effort induced subclavian vein thrombosis, also known as Paget-Schroetter syndrome (PSS) can be treated non-operatively with direct oral anticoagulation (AC), with percutaneous catheter directed thrombolysis (CDT), first rib resection (FRR), or a combination of treatments. Currently, there is no consensus on the optimal management of PSS. The objective of this study was to summarise the current evidence for management of PSS with explicit attention to the clinical outcomes of different management strategies. The main questions to be addressed were: Is surgical management of PSS consisting of CDT followed by FRR superior to non-operative management with AC? Does the use of CDT improve the outcomes of non-operative treated patients? Does the use of CDT improve the outcomes of surgical treated patients with PSS?