Format

Send to

Choose Destination
J Endovasc Ther. 2000 Aug;7(4):302-8.

Effort subclavian vein thrombosis: evolution of management.

Author information

1
Department of Surgery, Charleston Area Medical Center, Robert C. Byrd Health Sciences Center of West Virginia University, Charleston, USA. ali.aburahma@camcare.com

Abstract

PURPOSE:

To analyze changes in the management of effort subclavian vein thrombosis at our institution.

METHODS:

Records of 23 patients with effort subclavian vein thrombosis treated over a 10-year period were analyzed to compare the results of conventional therapy (heparin/warfarin) used in the first half of this period to a multimodality treatment strategy (thrombolysis and other adjunctive treatment as indicated, e.g., first rib resection, angioplasty/stenting, and vein reconstruction). Diagnostic testing included duplex ultrasound and venography. All patients had at least 1-year follow-up.

RESULTS:

Eight patients (7 men; mean age 34 years, range 15-54) had conventional treatment (group A) and 15 patients (14 men; mean age 36 years, range 17-55) had multimodality therapy (group B). Demographics and clinical characteristics were comparable for both groups. Initial thrombolysis was achieved in 14 (93%) group B patients; 10 received adjunctive treatment to relieve external compression or vein stenosis. Four patients had successful first or cervical rib resection and scalenectomy, and first rib resection followed by angioplasty/stenting was successful in 2. However, angioplasty and stenting alone failed in 2 patients, while venous reconstruction was successful in only 1 of 2 cases. Mean follow-up was 72 months in group A patients and 59 months in group B. One (13%) group A patient and 12 (80%) group B patients demonstrated total venous recanalization and symptom resolution (p = 0.003). Overall, clinical resolution (total and partial symptom relief) was achieved in 3 (38%) group A patients and 13 (87%) group B patients (p = 0.026).

CONCLUSIONS:

Initial lytic therapy followed by adjunctive treatment to relieve external venous compression or venous stenosis is effective in treating patients with effort subclavian vein thrombosis.

PMID:
10958295
DOI:
10.1177/152660280000700408
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center