Riten Kumar1, Katherine Harsh2, Surbhi Saini3, Sarah H O'Brien4, Joseph Stanek5, Patrick Warren6, Jean Giver5, Michael R Go7, Bryce A Kerlin4. 1. Division of Pediatric Hematology/Oncology, Nationwide Children's Hospital, Columbus, OH; Department of Pediatrics, The Ohio State University, Columbus, OH. Electronic address: riten.kumar@nationwidechildrens.org. 2. College of Medicine, The Ohio State University, Columbus, OH. 3. Division of Pediatric Hematology/Oncology, Hershey Children's Hospital, Hershey, PA; Department of Pediatrics, Penn State University, Hershey, PA. 4. Division of Pediatric Hematology/Oncology, Nationwide Children's Hospital, Columbus, OH; Department of Pediatrics, The Ohio State University, Columbus, OH. 5. Division of Pediatric Hematology/Oncology, Nationwide Children's Hospital, Columbus, OH. 6. Department of Pediatrics, The Ohio State University, Columbus, OH; Division of Interventional Radiology, Nationwide Children's Hospital, Columbus, OH. 7. Department of Vascular Diseases and Surgery, The Ohio State University, Columbus, OH.
Abstract
OBJECTIVE: To investigate treatment-related outcomes, namely radiological clot resolution, post-thrombotic syndrome (PTS), and health related quality-of-life (HRQoL) scores, in children with Paget-Schroetter syndrome (PSS) undergoing multidisciplinary management, including anticoagulation and decompressive rib-resection surgery, with or without thrombolytic therapy. STUDY DESIGN: We identified all patients treated for PSS at our institution between the years 2010 and 2017. Baseline clinical and radiologic data were abstracted from medical records. Two validated survey instruments to quantify PTS and HRQoL were mailed to eligible patients. Standard statistical methods were used to summarize these measures. RESULTS: In total, 22 eligible patients were identified; 10 were treated with thrombolysis followed by anticoagulation and rib resection, and 12 were treated with anticoagulation and rib resection alone. Nineteen patients responded to the survey instruments. Median age at deep vein thrombosis diagnosis and survey completion were 16.3 and 20.4 years, respectively. Nineteen of 22 patients had thrombus resolution on radiologic follow-up. Fourteen of 19 survey respondents reported signs/symptoms of PTS of which the majority (12/14) reported mild PTS. Aggregate total, physical, and psychosocial HRQoL scores reported were 90.6, 96.7, and 93.3, respectively. Thrombolytic therapy was not associated with a significant improvement in radiologic, clinical or HRQoL outcomes. CONCLUSIONS: Most patients with PSS had complete thrombus resolution on imaging. Only 11% of survey respondents reported moderate PTS. The entire cohort reported excellent HRQoL scores. The role for thrombolytic therapy in the management of childhood PSS remains incompletely elucidated.
OBJECTIVE: To investigate treatment-related outcomes, namely radiological clot resolution, post-thrombotic syndrome (PTS), and health related quality-of-life (HRQoL) scores, in children with Paget-Schroetter syndrome (PSS) undergoing multidisciplinary management, including anticoagulation and decompressive rib-resection surgery, with or without thrombolytic therapy. STUDY DESIGN: We identified all patients treated for PSS at our institution between the years 2010 and 2017. Baseline clinical and radiologic data were abstracted from medical records. Two validated survey instruments to quantify PTS and HRQoL were mailed to eligible patients. Standard statistical methods were used to summarize these measures. RESULTS: In total, 22 eligible patients were identified; 10 were treated with thrombolysis followed by anticoagulation and rib resection, and 12 were treated with anticoagulation and rib resection alone. Nineteen patients responded to the survey instruments. Median age at deep vein thrombosis diagnosis and survey completion were 16.3 and 20.4 years, respectively. Nineteen of 22 patients had thrombus resolution on radiologic follow-up. Fourteen of 19 survey respondents reported signs/symptoms of PTS of which the majority (12/14) reported mild PTS. Aggregate total, physical, and psychosocial HRQoL scores reported were 90.6, 96.7, and 93.3, respectively. Thrombolytic therapy was not associated with a significant improvement in radiologic, clinical or HRQoL outcomes. CONCLUSIONS: Most patients with PSS had complete thrombus resolution on imaging. Only 11% of survey respondents reported moderate PTS. The entire cohort reported excellent HRQoL scores. The role for thrombolytic therapy in the management of childhood PSS remains incompletely elucidated.
Authors: N Angle; H A Gelabert; M M Farooq; S S Ahn; D R Caswell; J A Freischlag; H I Machleder Journal: Ann Vasc Surg Date: 2001-01 Impact factor: 1.466
Authors: Leonardo R Brandão; Suzan Williams; Walter H A Kahr; Clodagh Ryan; Michael Temple; Anthony K C Chan Journal: Acta Haematol Date: 2006 Impact factor: 2.195
Authors: Leonardo R Brandão; Suzan Williams; Walter H A Kahr; Clodagh Ryan; Michael Temple; Anthony K C Chan Journal: Acta Haematol Date: 2006 Impact factor: 2.195