Combined jugular and subclavian vein thrombosis following assisted reproductive technology--new observation.
OBJECTIVE
To study the predilection of jugular and subclavian vein thrombosis in patients going through assisted reproductive technology (ART). This technology puts women at high risk of developing the ovarian hyperstimulation syndrome (OHSS) and thrombotic events.


METHODS
Study cases.


METHODS
Large Academic Medical Center.


METHODS
Five women who developed jugular and subclavian vein thrombosis following ART were included in the study.


METHODS
The deep vein thrombosis was demonstrated by ultrasound Doppler or computerized tomography angiography. All women were interviewed and data obtained from outpatient and hospital medical charts. Magnetic resonance imaging and complete thrombophilic profile workup was performed in each woman. Open biopsy from the lesions was taken from one of the women.


METHODS
Correlation between mechanical branchial cysts filled with fluid during OHSS and jugular and subclavian vein thrombosis.


RESULTS
Five women developed jugular and subclavian vein thrombosis following ART. They were found to harbor clusters of rudimentary branchial cysts filled with fluid at the time of OHSS, which compressed the jugular and subclavian veins at their junction at the base of the neck. Four patients (80%) were found to be carriers of factor V Leiden.


CONCLUSIONS
Predilection of jugular and subclavian vein thrombosis early in pregnancy is the result of mechanical compression mediated by rudimentary branchial cysts filled with fluid during OHSS, particularly in subjects who are carriers of factor V Leiden.
Salomon
Ophira
O
The Amalia Biron Thrombosis and Hemostasis Research Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel. ophiras@sheba.health.gov.il
Schiby
Ginette
G
Heiman
Zehava
Z
Avivi
Kamila
K
Sigal
Carol
C
Levran
David
D
Dor
Jeushua
J
Itzchak
Yacov
Y
D000328:Adult; D005260:Female; D006801:Humans; D007601:Jugular Veins; D016471:Ovarian Hyperstimulation Syndrome / Q000175:diagnosis / Q000209:etiology*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000209:etiology*; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D013350:Subclavian Vein; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000209:etiology; D055815:Young Adult