[Therapy and the natural course of axillary vein thrombosis--review of 765 patients and analysis of our personal patient sample].
Thrombosis of the axillary vein is a rare event. The incidence of 0.5, -1.5% of all venous thromboses makes comparative studies concerning therapy in a single center impossible. 15 own patients and 750 patients with axillary vein thrombosis collected from literature were studied, to compare the different therapeutic modalities. 36% received no therapy (NV), 15% anticoagulation (AG: heparin, warfarin, coumarins), 18% thrombolytic therapy (TL streptokinase, urokinase, locally and systemic) and 31% were treated by surgery (OP). Mean follow up was 32 months in NV, AG: 16, 3, TL: 35, OP: 38 months.


RESULTS
NV; No complaints: 12%, PTS I: 29%, PTS II: 25%, PTS III: 33%.


CONCLUSIONS
Untreated axillary vein thrombosis leads to functional disability of the affected extremity in one third. AG reduces this rate to 25%. After surgery and thrombolytic therapy a severe PTS is found only in 12% and 13.7% respectively. Loss of extremity was found in 5 cases (0.6%). A mechanic factor seems to be important in thrombogenesis. Rapid restitution of venous backflow and promotion of collateralisation is important to avoid disability of the patient. The low difference between AG and OP is pointed out indicating that invasive surgery should be restricted to special cases.
Hölzenbein
T
T
I. Chirurgische Universitätsklinik Wien.
Winkelbauer
F
F
Teleky
B
B
Krauss
R
R
Kretschmer
G
G
D000328:Adult; D001367:Axillary Vein / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011186:Postphlebitic Syndrome / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D013927:Thrombosis / Q000209:etiology / Q000601:surgery*
Therapie und natürlicher Verlauf der Axillarvenethrombose--Review von 765 Patienten und die Analyse des eigenen Krankengutes.