Percutaneous mechanical thrombectomy for the management of venous thoracic outlet syndrome.
OBJECTIVE
To describe the successful use of percutaneous mechanical thrombectomy as an adjunct to thrombolysis for acute subclavian vein thrombosis due to venous thoracic outlet syndrome.


METHODS
A 40-year-old man presented with arm swelling due to acute subclavian vein thrombosis and venous thoracic outlet syndrome. Percutaneous mechanical thrombectomy with the AngioJet device and thrombolysis were used to restore venous patency. Immediately following operative thoracic outlet decompression, the patient experienced rethrombosis, which was successfully treated using percutaneous mechanical thrombectomy. After 6 months, the patient remains symptom-free, with a patent subclavian vein by duplex ultrasonography.


CONCLUSIONS
Thrombus debulking or removal with percutaneous mechanical thrombectomy devices may reduce the amount or duration of thrombolytic therapy required, making treatment of venous thoracic outlet syndrome safer. Moreover, patients with recurrent thrombosis after thoracic outlet decompression may be safely treated with percutaneous mechanical thrombectomy, even when thrombolytic therapy is contraindicated.
Schneider
Darren B
DB
Division of Vascular Surgery, University of California San Francisco, California 94143, USA. SchneiderD@surgery.ucsf.edu
Curry
Thomas K
TK
Eichler
Charles M
CM
Messina
Louis M
LM
Gordon
Roy L
RL
Kerlan
Robert K
RK
D000328:Adult; D006801:Humans; D008297:Male; D013350:Subclavian Vein / Q000601:surgery*; D013901:Thoracic Outlet Syndrome / Q000150:complications*; D017131:Thrombectomy / Q000379:methods*; D015912:Thrombolytic Therapy / Q000379:methods*; D020246:Venous Thrombosis / Q000209:etiology / Q000628:therapy*