Lytic therapy in the treatment of axillary and subclavian vein thrombosis

Druy, Edward M.; Trout, Hugh H.; Giordano, Joseph; Hix, W. R.

doi:10.1067/mva.1985.avs0020821

Cited by 17 publications

(16 citation statements)

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“…Although this provides a compelling case for the utility of thrombolytic therapy, the most efficacious treatment strategy for Paget‐Schroëtter syndrome remains controversial. Although thrombolysis performed with urokinase improves venous patency and reduces symptoms (especially when initiated within 10 days of the onset of symptoms) [7], despite this aggressive strategy of prompt implementation of lytic therapy, 20% of cases are unsuccessful in restoring patency of the vein [8].…”

Section: Discussionmentioning

confidence: 99%

Paget‐Schroëtter syndrome: What to do?

Sevestre

Irwin

Ahari

et al. 2003

Cathet Cardio Intervent

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Section: Discussionmentioning

confidence: 99%

Paget‐Schroëtter syndrome: What to do?

Sevestre

Irwin

Ahari

et al. 2003

Cathet Cardio Intervent

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“…The subclavian vein may be compressed as it passes between the clavicle and subclavius muscle anteriorly and the first rib and scalenus anticus muscle posteriorly. 9,[53][54][55] In addition, a cervical rib, congenital fibromuscular band, muscle hypertrophy, or callus from a healing clavicular fracture may also compress the subclavian-axillary vein. 56,57 "Effort vein thrombosis" is SAVT caused by repetitive, strenuous activities.…”

Section: Subclavian-axillary Vein Thrombosismentioning

confidence: 99%

“…Nevertheless, most physicians direct initial treatment to the thrombotic occlusion, followed by correction of any extrinsic anatomic impingement and finally treatment of any underlying venous stenosis. 9,[53][54][55]65,66 Before institution of any therapy for SAVT, it is imperative that a complete evaluation of the venous system be performed to assess the location and extent of the thrombus burden as well as the extent of the collateral venous circulation.…”

Section: Subclavian-axillary Vein Thrombosismentioning

confidence: 99%

Upper Extremity Deep Venous Thrombosis

Patel¹

2001

Semin intervent Radiol

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As postulated by Virchow, 1 three factors are of primary importance in the development of deep venous thrombosis (DVT): abnormalities of blood flow, abnormalities of blood, and vascular injury (biochemical, local intimal trauma). The origin of DVT is frequently multifactorial, with components of Virchow's triad assuming variable importance in a given individual.Upper-extremity deep venous thrombosis (UEDVT) accounts for 1 to 4% of all cases of DVT. 2 UEDVT is most commonly the result of intimal damage from trauma (e.g., blunt, penetrating), venous cannulation (e.g., venous access lines and devices, intravenous drug abuse), mechanical irritation from indwelling catheters or pacemaker wires, or chemical irritation from infusates. 2 Less frequent causes of UEDVT include hypercoagulable states, malignancy, extrinsic compression by a mass (e.g., tumor, adenopathy), extrinsic anatomical impingement (e.g., PagetSchroetter syndrome), congenital and acquired webs, fibrosing mediastinitis, radiation, and increased resistance to venous return as a result of congestive heart failure. 2 Often the patient with UEDVT is asymptomatic or may present only with a complaint that his/her central venous access not functioning (Fig. 1). The symptoms will depend on the location of the thrombosis. A patient with UEDVT of the central veins may present with swelling and pain of the arm and neck or face, or both; fever; sepsis; or pulmonary embolus. Physical examination may show prominent superficial veins in the neck and shoulder. A patient with isolated upper-extremity peripheral venous thrombosis may present with local redness, tenderness, and increased warmth of the extremity. The swelling may only involve a portion of ABSTRACT Much attention is paid to lower-extremity deep venous thrombosis and its untoward short-and long-term sequelae. However, upper-extremity deep venous thrombosis (UEDVT) can be equally disabling and even life threatening, as in cases of superior vena cava syndrome. The mainstay of therapy for UEDVT is anticoagulation. In selected cases catheter-directed thrombolytic therapy may be needed to (1) rapidly remove the extensive thrombus, (2) reveal the underlying causative lesion, and (3) guide its appropriate treatment.Objectives: On completion of this article, the reader will (1) understand the etiology, incidence and risk of UEDVT (2) learn about the treatment options for superior vena cava syndrome (3) comprehend the treatment options for subclavian-axillary vein thrombosis. Accreditation: Tufts University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. TUSM takes full responsibility for the content, quality, and scientific integrity of this continuing education activity. Credit: Tufts University School of Medicine designates this education activity for a maximum of 1.0 hour credit toward the AMA Physicians Recognition Award in category one. Each physician should claim only those hours that he/she actually spent in...

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“…In the typical acute ASVT clot, lysis is usually prompt, within 24 hours. Successful lysis of the clot has been reported in 78% to 100% of cases, [28][29][30][31] and complication rates are low (Fig. 2).…”

Section: Primary Asvtmentioning

confidence: 99%

Central Venous Thrombolysis/PTA/Stenting

Brady¹,

Swischuk

Castañeda

et al. 2000

Semin intervent Radiol

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Central venous stenosis, occlusion, and thrombosis are complications that are being encountered in increasing frequency. These lesions can be directly related to four main causes: neointimal fibroplasia, trauma, tumor, and mediastinal fibrosis. The clinical situation in which these lesions present and the indications and goals of treatment are quite varied. To better discuss this heterogenous patient population, this article will be separated into two main anatomic divisions: axillary/subclavian veins and superior vena cava/brachiocephalic veins. Management of central venous stenosis and occlusions, while using many of the same approaches and equipment used in the arterial system, is a very different and often frustrating endeavor. Interventional radiologists who enter into the treatment of these lesions must work closely with our medical and surgical colleagues and understand the longterm commitment required to offer optimal care to these patients. Because of many recent technologic advances and relatively poor results of surgical and conservative treatment options, interventional radiologic techniques have evolved into the treatment of choice for many of these lesions. AXILLARY/SUBCLAVIAN VEINS Axillosubclavian vein thrombosis (ASVT) is a relatively uncommon entity comprising 1% to 2%ABSTRACT This article outlines the treatment of central venous occlusion and thrombosis. It analyzes the main causes of these entities: fibroplasias, trauma, tumor, and mediastinal fibrosis. The article outlines the salient features of the management of these problems with thrombolytics, stents, and angioplasty.

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Lytic therapy in the treatment of axillary and subclavian vein thrombosis

Cited by 17 publications

References 0 publications

Paget‐Schroëtter syndrome: What to do?

Paget‐Schroëtter syndrome: What to do?

Upper Extremity Deep Venous Thrombosis

Central Venous Thrombolysis/PTA/Stenting

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