Ján Sýkora1, Kamil Zeleňák2, Martin Vorčák1, Adam Krkoška1, Štefánia Vetešková1, Martina Sýkorová3, Jozef Sivák4, Ľuboš Hlinka5, Igor Šinák5. 1. Clinic of Radiology, Comenius University's Jessenius Faculty of Medicine and University Hospital, Kollárova 2, 036 59, Martin, Slovakia. 2. Clinic of Radiology, Comenius University's Jessenius Faculty of Medicine and University Hospital, Kollárova 2, 036 59, Martin, Slovakia. kamil.zelenak@uniba.sk. 3. Vaša ambulancia Ltd., Prieložtek 1, 036 01, Martin, Slovakia. 4. Middle-Slovak Institute of Cardiovascular Diseases, Cesta k nemocnici 1, 974 01, Banská Bystrica, Slovakia. 5. Department of Vascular Surgery, University Hospital, Kollárova 2, 036 59, Martin, Slovakia.
Abstract
BACKGROUND: Venous thoracic outlet syndrome resulting in the upper limb deep venous thrombosis is known as Paget-Schroetter syndrome or effort thrombosis. A general treatment algorithm includes catheter-directed thrombolysis followed by surgical thoracic outlet decompression. There are limited data regarding endovascular treatment of rethrombosis presenting early after the surgery. CASE PRESENTATION: Two cases of early rethrombosis successfully treated with percutaneous mechanical thrombectomy by two different techniques are described. In both cases, rethrombosis was diagnosed soon after thrombolysis and first rib resection with scalenectomy. After 12 months, both patients remain symptom-free, with patent subclavian veins confirmed by duplex ultrasonography. CONCLUSION: Percutaneous mechanical thrombectomy devices may offer a safe treatment option for patients with recurrent thrombosis after thoracic outlet surgery, even when thrombolytic therapy is contraindicated.
BACKGROUND:Venous thoracic outlet syndrome resulting in the upper limb deep venous thrombosis is known as Paget-Schroetter syndrome or effort thrombosis. A general treatment algorithm includes catheter-directed thrombolysis followed by surgical thoracic outlet decompression. There are limited data regarding endovascular treatment of rethrombosis presenting early after the surgery. CASE PRESENTATION: Two cases of early rethrombosis successfully treated with percutaneous mechanical thrombectomy by two different techniques are described. In both cases, rethrombosis was diagnosed soon after thrombolysis and first rib resection with scalenectomy. After 12 months, both patients remain symptom-free, with patent subclavian veins confirmed by duplex ultrasonography. CONCLUSION: Percutaneous mechanical thrombectomy devices may offer a safe treatment option for patients with recurrent thrombosis after thoracic outlet surgery, even when thrombolytic therapy is contraindicated.
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