title: Treatment of axillosubclavian vein thrombosis: a novel technique for rapid removal of clot using low-dose thrombolysis.
abstract: OBJECTIVE
  To report successful combined percutaneous mechanical thrombectomy and pharmacological lysis for axillosubclavian vein thrombosis, with rapid clot removal at a single setting using low-dose thrombolysis.
  
  
  METHODS
  Two consecutive patients presented with arm swelling; the diagnosis of axillosubclavian vein thrombosis was confirmed with duplex ultrasound. Both patients were treated percutaneously with the Solera mechanical thrombectomy device, after which 5 mg of tissue plasminogen activator were delivered within approximately 10 minutes via the Trellis infusion catheter to remove any residual thrombus. Completion venography and serial duplex ultrasound scans in follow-up demonstrated widely patent axillosubclavian veins with no residual thrombus in both cases.
  
  
  CONCLUSIONS
  Standard treatment of axillosubclavian vein thrombosis may require 12 to 36 hours, with multiple trips to the angiography suite. The novel technique combining mechanical thrombectomy and pharmacological lysis can be performed safely and successfully at a single setting with a small dose of the lytic drug.
authors.affiliation: Division of Vascular Surgery, Stanford University Medical Center, Stanford University, Stanford, California 94305, USA. farko@stanford.edu
authors.forename: Frank R
authors.initials: FR
authors.lastname: Arko
authors.forename: Paul
authors.initials: P
authors.lastname: Cipriano
authors.forename: Eugene
authors.initials: E
authors.lastname: Lee
authors.forename: Konstantinos A
authors.initials: KA
authors.lastname: Filis
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Zarins
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Fogarty
mesh_terms: D000328:Adult; D000368:Aged; D001367:Axillary Vein / Q000000981:diagnostic imaging; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D013350:Subclavian Vein / Q000000981:diagnostic imaging; D017131:Thrombectomy; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage; D018616:Ultrasonography, Doppler, Duplex; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy*
chemical_list: D010959:Tissue Plasminogen Activator