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Case Reports
. 2015 Oct 1:2015:bcr2015212021.
doi: 10.1136/bcr-2015-212021.

Rock climbing-related subclavian vein thrombosis

Christoph Lutter  1 , Erik Monasterio  2 , Volker Schöffl  3
Affiliations
Case Reports

Rock climbing-related subclavian vein thrombosis

Christoph Lutter et al. BMJ Case Rep. .

Abstract

Paget-Schroetter syndrome, also known as upper extremity deep venous thrombosis (UEDVT), is a rare condition, characterised by a (sub-) total occlusion of the axillary-subclavian venous system due to thrombosis. UEDVT is the most common vascular condition among athletes so far; although the general incidence is low, this problem will become more frequent as a result of increased participation in climbing sports. The purpose of this report is to illustrate two cases in rock climbers where UEDVT developed during rock climbing or bouldering. Fortunately, both patients were diagnosed relatively early after the symptoms began, despite the ambiguity of UEDVT symptoms. This relatively unfamiliar condition may become more highly recognised as a potentially serious differential diagnosis of unspecific pain of the shoulder. Rock climbers are disposed to develop UEDVT due to frequent stress on the upper extremities during training or competition.

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Figures

Figure 1
Figure 1
Schematic figure showing the venous system of the shoulder/arm region with passage to superior vena cava. *1: superior vena cava, *2: brachiocephalic veins, *3: jugular veins, *4: subclavian veins, *5: cephalic veins, *6: axillary veins, *7: passage to brachial and basilic veins. # Numbers showing number of sonographic vein classification (modified according to Scholz6).
Figure 2
Figure 2
Digital subtraction angiography of the left shoulder/arm venous system. (A) Near-total occlusion of basilic-axillary-subclavian venous complex. (B) Clearly identifiable collaterals around occluded basilic-axillary-subclavian veins. (C) The cephalic vein is well vascularised (patient 1, January 2008).
Figure 3
Figure 3
Phlebography of the left shoulder-arm venous system. The near-total occlusion of basilic-axillary-subclavian venous complex can be seen whereas remaining venous drainage is provided by cephalic vein and collaterals (patient 1, January 2008).
Figure 4
Figure 4
Subcutaneous venous collaterals. Right side: 10 years after upper extremity deep venous thrombosis (UEDVT), left side: 5 years after UEDVT (patient 1, May 2015).
See this image and copyright information in PMC

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