- Paget-Schroetter syndrome (PSS), also known as effort thrombosis, involves spontaneous subclavian vein thrombosis that is often associated with repetitive arm motions. It was first described in the late 19th century and is caused by abnormal anatomy at the thoracic outlet that compresses the subclavian vein. Symptoms include swelling and dilated veins in the affected arm. Treatment involves blood thinners, catheter-directed thrombolysis, and potentially surgical decompression of the thoracic outlet to relieve compression. Outstanding questions remain regarding optimal treatment approaches and long-term outcomes.