Clinical Presentation

A 31-year-old man presents with marked pain and swelling of the left arm.

(A) Left upper extremity venography shows complete occlusion (large arrow) of the subclavian vein at the thoracic outlet and intraluminal thrombus (small arrows) in the axillary and subclavian veins. (B) Venography after thrombolysis shows stenosis at the thoracic inlet (arrow).

Differential Diagnosis

• Paget von Schroetter syndrome (PSS): Indicated by complete subclavian vein occlusion at the thoracic outlet with associated intraluminal thrombus.

Essential Facts