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We report the case of a younger, physically active patient who presented at the emergency department with swelling, pain, and bluish discoloration of the left arm, with clinical examination identifying effort-induced deep vein thrombosis of the arm (Paget-Schroetter syndrome). After unsuccessful medication treatment with a therapy dose of low-molecular-weight heparin, the patient was treated with an endovascular procedure – percutaneous aspiration thrombectomy. The procedure was successful, with the establishment of peripheral flow through the subclavian, axillary, and cephalic vein despite some thrombotic masses remaining. Before discharge, the patient was placed on peroral anticoagulation treatment with rivaroxaban. Additional imaging was performed during treatment of the superior thoracic aperture, confirming the diagnosis. Expanded laboratory testing showed values within normal limits. Follow-up showed regression of the symptoms. Color Doppler ultrasound and clinical examination verified maintenance of peripheral flow through the affected veins, with residual small thrombi and the development of collaterals. The patient was subsequently considered for decompression therapy by removing the first rib as a permanent solution for the symptoms. [ABSTRACT FROM AUTHOR]