Effort thrombosis: role of interventional therapy.
Effort thrombosis, a form of axillary-subclavian vein occlusion in young people, was identified in patients referred over a 5-year period. Eleven of 120 patients (9%) with venous occlusion from many causes had effort thrombosis. They were treated acutely with heparin and then by thrombolysis, angioplasty, surgical bypass, or a combination. Five of the 10 patients with thrombolysis or surgery had patent veins on follow-up venography, but 9 of these later developed axillary-subclavian reocclusion. By later follow-up, however, all patients were asymptomatic at the time of collateral vein formation. We conclude that effort thrombosis leads to recurrent occlusion of the axillary-subclavian vein, short-term (12-month) recurrence of symptoms with exercise, and progressive compensatory collateral vein development. Radiographic documentation of reestablished venous flow is important, and can be used to guide the completion of treatment.
Grassi
C J
CJ
Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115.
Bettmann
M A
MA
D000293:Adolescent; D000328:Adult; D000800:Angioplasty, Balloon; D001367:Axillary Vein / Q000000981:diagnostic imaging; D015444:Exercise; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011859:Radiography; D012008:Recurrence; D013350:Subclavian Vein / Q000000981:diagnostic imaging; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*
D006493:Heparin