Paget-Schroetter disease echocardiography or ultrasound: Difference between revisions

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{{ Paget-Schroetter disease }}
 
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== Overview ==
 
* [[Paget-Schroetter disease]] is commonly diagnosed with history and physical examinations. However imaging is usually utilized to confirm the diagnose. [[Duplex ultrasound]] is an accepted initial test and the [[Gold standard (test)|gold standard]] imaging of [[Paget-Schroetter disease]]. Since this diagnostic tool is not fully appropriate to exclude the Paget-Schroetter disease, normal Duplex ultrasound in a highly suspected patient require further investigations.
 
== Ultrasound ==
 
* [[Duplex ultrasound]] is the [[Gold standard (test)|gold standard]] method to diagnose [[Paget-Schroetter disease|Paget-Schroetter]] ([[Paget–Schroetter disease|effort thrombosis]]).<ref name="HanggeRotellini-Coltvet2017">{{cite journal|last1=Hangge|first1=Patrick|last2=Rotellini-Coltvet|first2=Lisa |last3=Deipolyi|first3=Amy R. |last4=Albadawi|first4=Hassan |last5=Oklu|first5=Rahmi |title=Paget-Schroetter syndrome: treatment of venous thrombosis and outcomes|journal=Cardiovascular Diagnosis and Therapy|volume=7|issue=S3|year=2017|pages=S285–S290|issn=22233652|doi=10.21037/cdt.2017.08.15}}</ref>
* [[Medical ultrasonography|Doppler ultrasonography]] is the best initial test to evaluate a patient with suspected [[Paget-Schroetter disease]] (also known as [[Paget–Schroetter disease|Effort thrombosis]]).<ref name="pmid21079709">{{cite journal| author=Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK| title=Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis. | journal=West J Emerg Med | year= 2010 | volume= 11 | issue= 4 | pages= 358-62 | pmid=21079709 | doi= | pmc=2967689 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21079709  }}</ref> There are some convenient features of this test that make it a proper initial imaging. These features include:
** Low cost <ref name="pmid210797092">{{cite journal| author=Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK| title=Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis. | journal=West J Emerg Med | year= 2010 | volume= 11 | issue= 4 | pages= 358-62 | pmid=21079709 | doi= | pmc=2967689 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21079709  }}</ref>
** Availability
** Portability
** [[Specificity (tests)|Specificity]] of 93%<ref name="Rosa SalazarOtálora Valderrama2015">{{cite journal|last1=Rosa Salazar|first1=Vladimir|last2=Otálora Valderrama|first2=Sonia del Pilar|last3=Hernández Contreras|first3=María Encarnación|last4=García Pérez|first4=Bartolomé|last5=Arroyo Tristán|first5=Andrés del Amor|last6=García Méndez|first6=María del Mar|title=Multidisciplinary Management of Paget-Schroetter Syndrome. A Case Series of Eight Patients|journal=Archivos de Bronconeumología (English Edition)|volume=51|issue=8|year=2015|pages=e41–e43|issn=15792129|doi=10.1016/j.arbr.2015.05.026}}</ref>
** [[Sensitivity (tests)|Sensitivity]] of >80%<ref name="Rosa SalazarOtálora Valderrama20152">{{cite journal|last1=Rosa Salazar|first1=Vladimir|last2=Otálora Valderrama|first2=Sonia del Pilar|last3=Hernández Contreras|first3=María Encarnación|last4=García Pérez|first4=Bartolomé|last5=Arroyo Tristán|first5=Andrés del Amor|last6=García Méndez|first6=María del Mar|title=Multidisciplinary Management of Paget-Schroetter Syndrome. A Case Series of Eight Patients|journal=Archivos de Bronconeumología (English Edition)|volume=51|issue=8|year=2015|pages=e41–e43|issn=15792129|doi=10.1016/j.arbr.2015.05.026}}</ref>
** Non-invasive
* Based on some [[Randomized controlled trial|randomized trial]] [[duplex ultrasound]] has a [[Sensitivity (tests)|sensitivity]] of 78-100% and [[Specificity (tests)|Specificity]] of 82-100%. <ref name="IlligDoyle2010">{{cite journal|last1=Illig|first1=Karl A.|last2=Doyle|first2=Adam J.|title=A comprehensive review of Paget-Schroetter syndrome|journal=Journal of Vascular Surgery|volume=51|issue=6|year=2010|pages=1538–1547|issn=07415214|doi=10.1016/j.jvs.2009.12.022}}</ref>
* An experienced technician is able to distinguish between [[Acute (medicine)|acute]] and [[Chronic (medical)|chronic]] [[thrombus]] using [[Duplex ultrasound]]. An [[Acute (medicine)|acute]] [[thrombus]] which is echolucent leads to a non-compressible vein without any flow. In the contrary, a [[Chronic (medical)|chronic]] [[thrombus]] will appear [[Echogenicity|echogenic]] and fibrotic with notable collateral veins. <ref name="IlligDoyle20103">{{cite journal|last1=Illig|first1=Karl A.|last2=Doyle|first2=Adam J.|title=A comprehensive review of Paget-Schroetter syndrome|journal=Journal of Vascular Surgery|volume=51|issue=6|year=2010|pages=1538–1547|issn=07415214|doi=10.1016/j.jvs.2009.12.022}}</ref>
* Some drawbacks of [[Duplex ultrasound|Duplex ultrasonography]] are:
** Inadequate ability to picture the central parts of the [[Subclavian vein|Subclavian]] and [[Brachiocephalic vein|Innominate veins]] <ref name="IlligDoyle20104">{{cite journal|last1=Illig|first1=Karl A.|last2=Doyle|first2=Adam J.|title=A comprehensive review of Paget-Schroetter syndrome|journal=Journal of Vascular Surgery|volume=51|issue=6|year=2010|pages=1538–1547|issn=07415214|doi=10.1016/j.jvs.2009.12.022}}</ref>
** Inadequate ability to distinguish central veins from an enlarged collateral vein<ref name="IlligDoyle20105">{{cite journal|last1=Illig|first1=Karl A.|last2=Doyle|first2=Adam J.|title=A comprehensive review of Paget-Schroetter syndrome|journal=Journal of Vascular Surgery|volume=51|issue=6|year=2010|pages=1538–1547|issn=07415214|doi=10.1016/j.jvs.2009.12.022}}</ref>
** Highly technician dependent<ref name="Thompson20122">{{cite journal|last1=Thompson|first1=Robert|title=Comprehensive Management of Subclavian Vein Effort Thrombosis|journal=Seminars in Interventional Radiology|volume=29|issue=01|year=2012|pages=044–051|issn=0739-9529|doi=10.1055/s-0032-1302451}}</ref>
** Findings could be affected by superimposed [[clavicle]] and deepness of [[Subclavian vein]] in the neck<ref name="Thompson2012">{{cite journal|last1=Thompson|first1=Robert|title=Comprehensive Management of Subclavian Vein Effort Thrombosis|journal=Seminars in Interventional Radiology|volume=29|issue=01|year=2012|pages=044–051|issn=0739-9529|doi=10.1055/s-0032-1302451}}</ref>
** [[False negative|False negative rate]] of 30% (which makes [[Duplex ultrasound|Duplex ultrasonography]] an improper diagnostic tool to exclude the [[Paget-Schroetter disease]])<ref name="Thompson20123">{{cite journal|last1=Thompson|first1=Robert|title=Comprehensive Management of Subclavian Vein Effort Thrombosis|journal=Seminars in Interventional Radiology|volume=29|issue=01|year=2012|pages=044–051|issn=0739-9529|doi=10.1055/s-0032-1302451}}</ref>
* [[Ultrasound]] as a non-invasive imaging could be used postoperatively to evaluate venous flow and caliber.<ref name="Rubin2009">{{cite journal|last1=Rubin|first1=Joseph|title=Invited Commentary|journal=The Annals of Thoracic Surgery|volume=87|issue=2|year=2009|pages=422|issn=00034975|doi=10.1016/j.athoracsur.2008.11.058}}</ref>


==References==
==References==

Revision as of 22:30, 3 June 2020


Overview

  • Paget-Schroetter disease is commonly diagnosed with history and physical examinations. However imaging is usually utilized to confirm the diagnose. Duplex ultrasound is an accepted initial test and the gold standard imaging of Paget-Schroetter disease. Since this diagnostic tool is not fully appropriate to exclude the Paget-Schroetter disease, normal Duplex ultrasound in a highly suspected patient require further investigations.

Ultrasound

References

  1. ↑ Hangge, Patrick; Rotellini-Coltvet, Lisa; Deipolyi, Amy R.; Albadawi, Hassan; Oklu, Rahmi (2017). "Paget-Schroetter syndrome: treatment of venous thrombosis and outcomes". Cardiovascular Diagnosis and Therapy. 7 (S3): S285–S290. doi:10.21037/cdt.2017.08.15. ISSN 2223-3652.
  2. ↑ Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK (2010). "Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis". West J Emerg Med. 11 (4): 358–62. PMC 2967689. PMID 21079709.
  3. ↑ Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK (2010). "Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis". West J Emerg Med. 11 (4): 358–62. PMC 2967689. PMID 21079709.
  4. ↑ Rosa Salazar, Vladimir; Otálora Valderrama, Sonia del Pilar; Hernández Contreras, María Encarnación; García Pérez, Bartolomé; Arroyo Tristán, Andrés del Amor; García Méndez, María del Mar (2015). "Multidisciplinary Management of Paget-Schroetter Syndrome. A Case Series of Eight Patients". Archivos de Bronconeumología (English Edition). 51 (8): e41–e43. doi:10.1016/j.arbr.2015.05.026. ISSN 1579-2129.
  5. ↑ Rosa Salazar, Vladimir; Otálora Valderrama, Sonia del Pilar; Hernández Contreras, María Encarnación; García Pérez, Bartolomé; Arroyo Tristán, Andrés del Amor; García Méndez, María del Mar (2015). "Multidisciplinary Management of Paget-Schroetter Syndrome. A Case Series of Eight Patients". Archivos de Bronconeumología (English Edition). 51 (8): e41–e43. doi:10.1016/j.arbr.2015.05.026. ISSN 1579-2129.
  6. ↑ Illig, Karl A.; Doyle, Adam J. (2010). "A comprehensive review of Paget-Schroetter syndrome". Journal of Vascular Surgery. 51 (6): 1538–1547. doi:10.1016/j.jvs.2009.12.022. ISSN 0741-5214.
  7. ↑ Illig, Karl A.; Doyle, Adam J. (2010). "A comprehensive review of Paget-Schroetter syndrome". Journal of Vascular Surgery. 51 (6): 1538–1547. doi:10.1016/j.jvs.2009.12.022. ISSN 0741-5214.
  8. ↑ Illig, Karl A.; Doyle, Adam J. (2010). "A comprehensive review of Paget-Schroetter syndrome". Journal of Vascular Surgery. 51 (6): 1538–1547. doi:10.1016/j.jvs.2009.12.022. ISSN 0741-5214.
  9. ↑ Illig, Karl A.; Doyle, Adam J. (2010). "A comprehensive review of Paget-Schroetter syndrome". Journal of Vascular Surgery. 51 (6): 1538–1547. doi:10.1016/j.jvs.2009.12.022. ISSN 0741-5214.
  10. ↑ Thompson, Robert (2012). "Comprehensive Management of Subclavian Vein Effort Thrombosis". Seminars in Interventional Radiology. 29 (01): 044–051. doi:10.1055/s-0032-1302451. ISSN 0739-9529.
  11. ↑ Thompson, Robert (2012). "Comprehensive Management of Subclavian Vein Effort Thrombosis". Seminars in Interventional Radiology. 29 (01): 044–051. doi:10.1055/s-0032-1302451. ISSN 0739-9529.
  12. ↑ Thompson, Robert (2012). "Comprehensive Management of Subclavian Vein Effort Thrombosis". Seminars in Interventional Radiology. 29 (01): 044–051. doi:10.1055/s-0032-1302451. ISSN 0739-9529.
  13. ↑ Rubin, Joseph (2009). "Invited Commentary". The Annals of Thoracic Surgery. 87 (2): 422. doi:10.1016/j.athoracsur.2008.11.058. ISSN 0003-4975.

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