Effort Subclavian Vein Thrombosis

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Effort subclavian vein thrombosis, also known as Paget-Schroetter syndrome, is a blood clot that occurs in the subclavian vein under the collarbone. A type of thoracic outlet syndrome, effort vein thrombosis usually occurs when the vein is compressed between the first rib and collarbone. 

Causes of Effort Vein Thrombosis

You may experience effort vein thrombosis if you have a large neck and upper-arm muscles or overexertion of those muscles. Other causes include: 

  • Presence of an extra rib above the first rib that compresses the subclavian vein
  • Previous collarbone or rib fracture 
  • An abnormal ligament that compresses the subclavian vein
  • Repetitive movement of the arm and shoulder with over the head extension 

Symptoms of effort vein thrombosis include:

  • Pain, swelling or congestion in the affected arm
  • Affected arm turns blue

Diagnosis & Treatment at UVA

At UVA, we can diagnose you by using these tests:

  • Ultrasound imaging
  • Venogram
  • Magnetic resonance venous (MRV) imaging

Your doctor may recommend anticoagulant medication to prevent blood clots from forming.

We offer the following treatments for subclavian vein problems.


Your doctor inserts a catheter into a vein in the arm and up to the clot's location under the collarbone. Medication helps dissolve or slowly break up the clot. You'll need to take anticoagulant medication after the procedure to prevent new clots.


You may require surgery to remove the segment of rib and the ligaments and muscles that cause vein compression. Removal prevents formation of new blood clots.

Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.