Management of Paget-Schroetter Syndrome: a Systematic Review and Meta-Analysis

Hoexum, Frank; Hoebink, Max; Coveliers, Hans M.E.; Wisselink, Willem; Jongkind, Vincent; Yeung, Kak Khee

doi:10.1016/j.ejvs.2023.08.065

Cited by 6 publications

(6 citation statements)

References 67 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Angioplasty balloons and stents are delivered percutaneously over the wire to the site of the clot, In general, with acute thrombus, thrombolysis or percutaneous thrombectomy will have been performed to remove acute friable clot. In vessels with chronic obstructive thrombo-fibrotic lesions, no pre-emptive declotting procedures are required ( 19 ). Balloon angioplasty can be employed with plain balloons, wall-modifying balloons (cutting or scoring), or high-pressure balloons ( 20 ).…”

Section: Introductionmentioning

confidence: 99%

“…Balloon angioplasty can be employed with plain balloons, wall-modifying balloons (cutting or scoring), or high-pressure balloons ( 20 ). If greater than 30% residual stenosis remains, bare metal or covered stents can be deployed to increase luminal diameter ( 19 ).…”

Section: Introductionmentioning

confidence: 99%

“…“The primary endpoint for these therapies was the resolution of >70% of thrombus. The immediate overall technical success rate for acute thrombus removal described in the literature is over 90% in CDT, 100% in PMT, and 100% for percutaneous thrombectomy systems ( 19 ). Technical success is associated with an equivalent rate of symptom relief.…”

Section: Introductionmentioning

confidence: 99%

“…More robust balloon angioplasty interventions carry the risk of rupture, intimal disruption with recurrent thrombosis, or perivascular inflammatory response, which may complicate any planned open decompressive procedure ( 4 , 29 ). Initial declotting followed by prompt first rib resection within 2 weeks of initial thrombosis demonstrates a greater than 90% success rate with significant symptom relief and return of full function in the upper extremity ( 19 ). In a systematic review that yielded 6 appropriate articles, early decompression surgery within two weeks after percutaneous declotting procedures appears safe and effective ( 30 ).…”

Section: Introductionmentioning

confidence: 99%

“…While there are no randomized controlled trials that can inform on the optimal therapeutic strategy for vTOS, a recent systematic review and meta-analysis strongly suggests that higher rates of thrombus removal and symptoms resolution is achievable with SCV thrombolysis, followed by first rib resection ( 19 , 34 ). Current clinical practice dictates that with the diagnosis of deep venous thrombosis (DVT) in the subclavian vein, anticoagulation therapy is commenced to minimize proximal and distal clot progression before consideration of the diagnosis and definitive management of vTOS ( 34 ).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Endovascular management of acute and subacute venous thoracic outlet syndrome

Davies,

Hart

2024

Front. Surg.

View full text Add to dashboard Cite

Approximately 3% of all patients presenting with Thoracic Outlet Syndrome have a venous etiology (vTOS), which is considered “effort thrombosis”. These patients will present with symptomatic deep venous thrombosis or focal subclavian vein (SCV) stenosis. Endovascular management of vTOS occurs in several phases: diagnostic, preoperative therapeutic intervention before decompression, postoperative interventions after decompression, and delayed interventions in the follow-up after decompression. In the diagnostic phase, dynamic SCV venography can establish functional vTOS. Approximately 4,000 patients have been treated for vTOS and reported in the literature since 1970. Declotting of the SCV was followed by surgical decompression in 53% of patients, while in the remainder, surgical decompression alone (18%), endovascular intervention alone (15%), or conservative therapy with anticoagulation (15%) was performed. The initial intervention was predominantly catheter-directed thrombolysis, with <10% of cases undergoing concomitant balloon angioplasty. 93% of cases were successful. In the postoperative phase, balloon angioplasty was performed to correct residual intrinsic SCV disease after vTOS decompression in under 15% of cases. Stents were rarely deployed. Symptom relief was reported as 94 ± 12% (mean ± SD) and 90 ± 23%, respectively for declotting with decompression and declotting alone. In the delayed phase, balloon angioplasty was performed in under 15% of cases to re-establish patency.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%