[The efficacy of local T-pa infusion in the treatment of axillary vein thrombosis].
BACKGROUND
We evaluated the results of local tissue plasminogen activator (t-PA) infusion in the treatment of axillary vein thrombosis.


METHODS
Fourteen male patients (mean age 23+/-2 years) who presented with pain and swelling in the arm were diagnosed as having axillary vein thrombosis. Besides physical examination, diagnoses were made with the use of venous Doppler ultrasound, duplex scanning or venography. Complaints were localized in the right upper arm in 10 patients, and in the left upper arm in four patients. Time to presentation from the onset of complaints ranged 1-3 days, 3-7 days, 7-10 days, and 10-14 days in six, three, two, and three patients, respectively. Infusion of t-PA (0.25 mg/kg) was performed for one hour via a venous catheter inserted to the distal part of the brachial vein. Venous patency was evaluated using Doppler ultrasound and venography.


RESULTS
Axillary vein was shown to be patent by venous Doppler ultrasound in eleven patients within a mean of 4.2 hours. Three patients who exhibited no improvement received another t-PA (0.05 mg/kg/h) infusion six hours after the initial treatment. Venous Doppler ultrasound showed almost complete patency of the lumen after six, seven, and 11 hours of the subsequent infusion, respectively. Following therapy, all the patients were administered prophylactic anti-aggregating treatment. On control examinations after three months, venous Doppler ultrasound and venography showed that the lumens were almost completely patent in 12 patients and two patients, respectively. No recurrences were detected.


CONCLUSIONS
Fibrinolytic agents yield high efficacy in the treatment of axillary vein thrombosis.
Bingöl
Hakan
H
Department of Cardiovascular Surgery, Gülhane Military School of Medicine, Ankara, Turkey. hbingol@gata.edu.tr
Cingoz
Faruk
F
Günay
Cemalettin
C
Demirkiliç
Ufuk
U
Yilmaz
Ahmet Turan
AT
Tatar
Harun
H
D000328:Adult; D001132:Arm / Q000098:blood supply*; D001367:Axillary Vein / Q000502:physiology*; D001783:Blood Flow Velocity; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D011673:Pulsatile Flow; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator