Effort Subclavian Vein Thrombosis: Evolution of Management
| Autor: | Patrick A. Robinson, Ali F. AbuRahma |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment First rib resection Venography 030204 cardiovascular system & hematology Subclavian Vein Catheterization 03 medical and health sciences 0302 clinical medicine Angioplasty medicine Humans Thrombolytic Therapy Radiology Nuclear Medicine and imaging 030212 general & internal medicine Vein Venous Thrombosis medicine.diagnostic_test business.industry Warfarin Anticoagulants Thrombolysis Middle Aged medicine.disease Combined Modality Therapy Surgery Stenosis medicine.anatomical_structure Adjunctive treatment Female Stents Radiology business Cardiology and Cardiovascular Medicine medicine.drug Follow-Up Studies |
| Zdroj: | Journal of Endovascular Therapy. 7:302-308 |
| ISSN: | 1545-1550 1526-6028 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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