[In situ thrombolysis in the treatment of venous thrombosis of effort in the arm].

Abstract

From March 1989 to March 1993, six athletic patients were treated in our institution by thrombolytic therapy for acute effort axillary-subclavian vein thrombosis in thoracic outlet syndrome. Mean age of these patients was 20 (range 14 to 27). An in situ infusion with urokinase (2,500 U/kg/h) and Heparin (100 U/kg/12 hours) was given during 64 hours (Range 14 to 72). Phlebography showed a complete reperfusion in three cases (the treatment began within an average period of 5.6 days), partial reperfusion in two cases (the treatment began within an average period of 8.5 days). In one case there was no reperfusion on phlebography: treatment began within an average period of 15 days. For this patient, a venous axillo-jugular bypass graft was performed. In all cases, there was no bleeding complication. A trans-axillary first rib resection was done three months later. Mean follow up was 31 months (range: two to 51 months). All patients recovered their previous physical status. Echo-Doppler exam showed normal subclavian vein flow in four cases, partial occlusion in one case and a total occlusion of the subclavian vein flow in one case. In this last case, the thrombolytic therapy failed to restore the permeability of the subclavian vein. Bypassgraft was patent. Axillary-subclavian vein thrombosis seen within a period of seven days should be treated by local thrombolytic therapy using urokinase and heparin.

• Authors: J D Pegis, X Papon, A Pasco, O Regnard, P Abraham, B Enon
• Journal: Journal des maladies vasculaires (J Mal Vasc) Vol. 22 Issue 3 Pg. 187-92 (Jul 1997) ISSN: 0398-0499 [Print] France
• Vernacular Title: Thrombolyse in situ dans le traitement des thromboses veineuses d'effort du membre supérieur.
• PMID: 9303935 (Publication Type: Clinical Trial, English Abstract, Journal Article)

Chemical References

• Fibrinolytic Agents
• Heparin
• Plasminogen Activators
• Urokinase-Type Plasminogen Activator

Topics

• Acute Disease
• Adolescent
• Adult
• Arm (blood supply)
• Drug Therapy, Combination
• Female
• Fibrinolytic Agents (therapeutic use)
• Heparin (therapeutic use)
• Humans
• Male
• Physical Exertion (physiology)
• Plasminogen Activators (therapeutic use)
• Prospective Studies
• Subclavian Vein
• Thrombolytic Therapy (methods)
• Thrombophlebitis (drug therapy, etiology)
• Urokinase-Type Plasminogen Activator (therapeutic use)