Abstract
Primary subclavian-axillary vein thrombosis, “Paget-Schroetter syndrome” is relatively rare, and the optimal treatment strategy remains controversial. A 37-year-old man, who had undergone transcatheter thrombolysis and thrombectomy 2 years previously for Paget-Schroetter syndrome, was admitted for recurrence of left arm swelling. He had been receiving anticoagulation treatment for 1 year after the procedure for persistent subclavian vein stenosis, and venography revealed severe recurrent stenosis of the subclavian vein. Through an infraclavicular approach, surgical decompression by first-rib resection was performed. Subsequently, the manubrium of the sternum was cut in an L-shape from the stump of the first rib to the sternal notch (Molina method), the clavicle was pulled upward and vein patch plasty was performed. After the procedure, his left arm swelling improved and he returned to work on anticoagulation medication. An infraclavicular approach and the Molina method can be useful to provide good exposure for subclavian vein plasty.
