A young basketball player develops an acute onset of subclavian vein thrombosis (effort thrombosis) after heavy exercise. What is the next step in management?

Effort thrombosis, also called Paget-von Schroetter syndrome, is the development of thrombosis of the axillary-subclavian vein as a result of injury or compression. It occurs primarily in young athletes and is disabling. When these patients are seen early, thrombolytic therapy is the first step in management and is followed by a venogram to detect correctable lesions. If effort thrombosis is associated with thoracic outlet syndrome, then thrombolytic therapy should be followed by cervical rib resection. If the condition is chronic, thrombolytic therapy might not be successful; these patients usually respond to limb elevation and anticoagulation.