G J Hicken1, F M Ameli. 1. Division of Vascular Surgery, Wellesley Hospital, University of Toronto, Ont.
Abstract
OBJECTIVE: To study, by literature review, the management of subclavian-axillary vein thrombosis (SAVT) and to make recommendations. DATA SOURCES: The MEDLINE database and cross-referenced articles. STUDY SELECTION: Key words subclavian-axillary vein thrombosis, venous thrombosis, Paget-Schroetter syndrome, anticoagulation, and thrombolysis were used to extract articles related to SAVT. DATA EXTRACTION: Independent extraction of articles by 2 observers. DATA SYNTHESIS: Although numerous studies are available in the literature, they vary widely in their patient selection, treatment methods, follow-up and conclusions. As such, the management of patients with SAVT remains controversial. CONCLUSIONS: Anticoagulation remains the initial treatment of choice for acute SAVT although there is definitely a role for thrombolysis and surgery in selected cases. Surgical intervention should be reserved for patients in whom there is a specific indication. Since chronic symptoms depend largely on the etiology of the disease, treatment should be tailored to address the causative factors. A multicentre, prospective study is necessary to evaluate the optimum management strategies for patients with SAVT.
OBJECTIVE: To study, by literature review, the management of subclavian-axillary vein thrombosis (SAVT) and to make recommendations. DATA SOURCES: The MEDLINE database and cross-referenced articles. STUDY SELECTION: Key words subclavian-axillary vein thrombosis, venous thrombosis, Paget-Schroetter syndrome, anticoagulation, and thrombolysis were used to extract articles related to SAVT. DATA EXTRACTION: Independent extraction of articles by 2 observers. DATA SYNTHESIS: Although numerous studies are available in the literature, they vary widely in their patient selection, treatment methods, follow-up and conclusions. As such, the management of patients with SAVT remains controversial. CONCLUSIONS: Anticoagulation remains the initial treatment of choice for acute SAVT although there is definitely a role for thrombolysis and surgery in selected cases. Surgical intervention should be reserved for patients in whom there is a specific indication. Since chronic symptoms depend largely on the etiology of the disease, treatment should be tailored to address the causative factors. A multicentre, prospective study is necessary to evaluate the optimum management strategies for patients with SAVT.
Authors: Grzegorz Rozmus; James P Daubert; David T Huang; Spencer Rosero; Burr Hall; Charles Francis Journal: J Interv Card Electrophysiol Date: 2005-06 Impact factor: 1.900