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Órgano Oficial de la Sociedad Mexicana de Angiología y Cirugía Vascular

2017, Number 4

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Rev Mex Angiol 2017; 45 (4)

Tratamiento actual de la trombosis venosa de esfuerzo axilo-subclavia (síndrome de Paget-Schröetter)

Castañeda-Gaxiola R, Rish-Fein L, Peña-Mercado F, Arias-Gómez E, Marquina-Ramírez ME, Fernández-López LJ

Language: Spanish
References: 18
Page: 149-153
PDF size: 108.12 Kb.


ABSTRACT


Introduction. Paget-Schröetter syndrome is a venous variant of thoracic outlet syndrome that courses with axillary-subclavian venous thrombosis secondary to repetitive traumatism provoked by clavicle and first rib compression over the vein.
Material and methods. We reviewed our experience of 29 confirmed cases of this entity. The 55% (7/ 29) received catheter directed thrombolysis, In 68% (20/29) trans-axillary first rib resection was performed.
Results. In one patient (1/29) partial first rib resection by sub clavicular approach was done. The 24% (7/29) did not receive any surgical intervention because of chronicity, the necessity to be transferred to another institution, costs, or not accepting the procedure. One vascular complication occurred and was solved by thoracotomy. There was no mortality associated.
Conclusions. It's accepted that the best treatment in acute cases is thrombolysis followed by elimination of the etiologic mechanical factor (remove the first rib). It is also recommended that surgical procedure should be performed by vascular surgeons due to the potential of complicat+ions.


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