AB215. SOH26AB_0084. Recurrent Paget-Schroetter syndrome managed with a single-session hybrid strategy: a case report
General Surgery Posters I

AB215. SOH26AB_0084. Recurrent Paget-Schroetter syndrome managed with a single-session hybrid strategy: a case report

Muhammad Haider Abbas1, Omer Yousif Omer1, Tim Scanlon2, Zeeshan Ahmed1

1Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland; 2Department of Interventional Radiology, University Hospital Limerick, Limerick, Ireland

Background: Contemporary venous thoracic outlet syndrome management is shifting toward single-session hybrid intervention, largely driven by reports showing 90–100% technical success, 85–100% early patency, and a substantially lower re-thrombosis rate (<10%) compared with staged catheter-directed thrombolysis (CDT) and delayed decompression, where recurrence may reach 25%. Despite these advantages, outcomes following early recurrence after apparently adequate decompression remain poorly defined.

Case Description: A previously healthy man in his 40s presented with acute axillo-subclavian deep venous thrombosis consistent with Paget-Schroetter syndrome (PSS). Initial CDT achieved substantial thrombus reduction but was followed by re-thrombosis within days. He subsequently underwent a single-session hybrid procedure combining mechanical thrombectomy, high-pressure balloon venoplasty, and thoracic outlet decompression via first rib resection and anterior scalenectomy. A second early recurrence required repeat thrombectomy and venoplasty. The hybrid approach restored antegrade flow with significant improvement in luminal calibre. Completion venography after the second intervention demonstrated a widely patent axillo-subclavian vein without residual stenosis. Duplex ultrasound at 6 weeks and at 3 months confirmed durable patency and normal haemodynamics. The patient achieved full symptomatic and functional recovery.

Conclusions: This case highlights the persistent risk of early re-thrombosis even after technically complete decompression. The overall course aligns with emerging hybrid-session data and reinforces the concept that combining thrombus clearance and decompression in a single operative episode reduces interval vulnerability and provides reliable patency when coupled with structured postoperative surveillance and timely re-intervention.

Keywords: Paget-Schroetter syndrome (PSS); thoracic outlet; venoplasty; hybrid procedure; case report

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab215
Cite this abstract as: Abbas MH, Omer OY, Scanlon T, Ahmed Z. AB215. SOH26AB_0084. Recurrent Paget-Schroetter syndrome managed with a single-session hybrid strategy: a case report. Mesentery Peritoneum 2026;10:AB215.

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