|Long-term results in patients treated with thrombolysis, thoracic inlet decompression, and subclavian vein stenting for Paget-Schroetter syndrome.|
|PMID: 11174819 Owner: NLM Status: MEDLINE|
|PURPOSE: In an effort to minimize long-term disability related to effort thrombosis of the subclavian vein, selected patients were treated with thrombolysis, thoracic inlet decompression, percutaneous transluminal angioplasty (PTA), and subclavian vein stenting. We evaluated the long-term outcomes of patients treated with this algorithm.
METHODS: Between 1994 and 2000, 23 patients were evaluated with effort thrombosis of the subclavian vein. Thrombolysis was instituted on an average of 9.4 days (range, 1-30 days) after initial onset of symptoms. Average time to clot lysis was 34 hours (range, 12-72 hours). After immediate supraclavicular thoracic inlet decompression, all patients underwent PTA. Fourteen patients with residual vein stenosis (>50%) after PTA underwent stenting of the subclavian vein. Complications in this series included three wound hematomas that required drainage in two patients and one subpleural hematoma that required thoracotomy for decompression.
RESULTS: All patients who underwent PTA are patent, with a mean follow-up of 4 years (range, 2-6 years). In the veins treated with stents, 9 of 14 veins are patent, with a mean follow-up of 3.5 years (range, 1-6 years). Two veins had early occlusions (2 days); two veins occluded at 1 year; and seven veins occluded at 3 years. Three of the patients (including those patients who experienced the early failed procedures) were later identified with factor V Leiden. Early failures also had clot extending into the brachial vein.
CONCLUSION: Patients with short-segment venous strictures after successful lysis and thoracic outlet decompression may safely be treated with subclavian venous stents and can expect long-term patency.
|P B Kreienberg; B B Chang; R C Darling; S P Roddy; P S Paty; W E Lloyd; D Cohen; B Stainken; D M Shah|
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|Type: Journal Article|
|Title: Journal of vascular surgery Volume: 33 ISSN: 0741-5214 ISO Abbreviation: J. Vasc. Surg. Publication Date: 2001 Feb|
|Created Date: 2001-02-22 Completed Date: 2001-03-22 Revised Date: 2012-10-03|
Medline Journal Info:
|Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: United States|
|Languages: eng Pagination: S100-5 Citation Subset: IM|
|Institute for Vascular Health and Disease, Albany Medical College, NY 12208, USA.|
|APA/MLA Format Download EndNote Download BibTex|
Activated Protein C Resistance
Angioplasty, Balloon, Coronary / adverse effects, instrumentation, methods*
Combined Modality Therapy
Decompression, Surgical / adverse effects, methods*
Factor V / analysis
Thrombolytic Therapy / adverse effects, methods*
Thrombosis / etiology, radiography, therapy*
|0/factor V Leiden; 9001-24-5/Factor V|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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