title: Combined jugular and subclavian vein thrombosis following assisted reproductive technology--new observation.
abstract: 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.
authors: The Amalia Biron Thrombosis and Hemostasis Research Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel. ophiras@sheba.health.gov.il
authors: Ophira
authors: O
authors: Salomon
authors: Ginette
authors: G
authors: Schiby
authors: Zehava
authors: Z
authors: Heiman
authors: Kamila
authors: K
authors: Avivi
authors: Carol
authors: C
authors: Sigal
authors: David
authors: D
authors: Levran
authors: Jeushua
authors: J
authors: Dor
authors: Yacov
authors: Y
authors: Itzchak
mesh_terms: 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