Primary subclavian-axillary vein thrombosis: consensus and commentary. 1996

R B Rutherford, and S N Hurlbert
Section of Vascular Surgery, University of Colorado School of Medicine, Denver, USA.

Fifteen multiple-choice questions concerning options in the management of primary subclavian-axillary vein thrombosis were discussed by a panel of experts and then voted upon by 25 attending vascular surgeons with a special interest in venous disease and considerable experience in subclavian-axillary vein thrombosis. The large majority favored, or agreed upon: (1) early clot removal for active, healthy patients with a need/desire to use the involved limb in work or sport; (2) catheter-directed thrombolysis as initial therapy; (3) further therapy based on follow-up positional venography; (4) surgical relief of demonstrated thoracic outlet compression after a brief period of anticoagulant therapy; (5) conservative therapy if post-lysis venogram showed either (a) no extrinsic compression or (b) a short residual occlusion; and (6) intervention for residual intrinsic lesions with over 50% narrowing. However, there was little unanimity regarding the most appropriate intervention for residual stenoses, with opinion split between surgical and percutaneous transluminal angioplasty. For residual symptomatic occlusion 66% favored jugular vein turndown; only 10% would perform first rib removal.

UI MeSH Term Description Entries
D010690 Phlebography Radiographic visualization or recording of a vein after the injection of contrast medium. Venography,Phlebographies,Venographies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000800 Angioplasty, Balloon Use of a balloon catheter for dilation of an occluded artery. It is used in treatment of arterial occlusive diseases, including renal artery stenosis and arterial occlusions in the leg. For the specific technique of BALLOON DILATION in coronary arteries, ANGIOPLASTY, BALLOON, CORONARY is available. Balloon Angioplasty,Dilation, Transluminal Arterial,Arterial Dilation, Transluminal,Arterial Dilations, Transluminal,Dilations, Transluminal Arterial,Transluminal Arterial Dilation,Transluminal Arterial Dilations
D001367 Axillary Vein The venous trunk of the upper limb; a continuation of the basilar and brachial veins running from the lower border of the teres major muscle to the outer border of the first rib where it becomes the subclavian vein. Axillary Veins,Vein, Axillary,Veins, Axillary
D013350 Subclavian Vein The continuation of the axillary vein which follows the subclavian artery and then joins the internal jugular vein to form the brachiocephalic vein. Subclavian Veins,Vein, Subclavian,Veins, Subclavian
D013927 Thrombosis Formation and development of a thrombus or blood clot in BLOOD VESSELS. Atherothrombosis,Thrombus,Blood Clot,Blood Clots,Thromboses
D015912 Thrombolytic Therapy Use of infusions of FIBRINOLYTIC AGENTS to destroy or dissolve thrombi in blood vessels or bypass grafts. Fibrinolytic Therapy,Thrombolysis, Therapeutic,Therapeutic Thrombolysis,Therapy, Fibrinolytic,Therapy, Thrombolytic,Fibrinolytic Therapies,Therapeutic Thrombolyses,Therapies, Fibrinolytic,Therapies, Thrombolytic,Thrombolyses, Therapeutic,Thrombolytic Therapies
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D017131 Thrombectomy Surgical removal of an obstructing clot or foreign material from a blood vessel at the point of its formation. Removal of a clot arising from a distant site is called EMBOLECTOMY. Aspiration Thrombectomy,Percutaneous Aspiration Thrombectomy,Aspiration Thrombectomies,Aspiration Thrombectomies, Percutaneous,Aspiration Thrombectomy, Percutaneous,Percutaneous Aspiration Thrombectomies,Thrombectomies,Thrombectomies, Aspiration,Thrombectomies, Percutaneous Aspiration,Thrombectomy, Aspiration,Thrombectomy, Percutaneous Aspiration

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