Endovascular management of venous thrombotic diseases of the upper torso and extremities

Melhem J Sharafuddin; Shiliang Sun; Jamal J Hoballah

doi:10.1016/S1051-0443(07)61861-2

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Endovascular management of venous thrombotic diseases of the upper torso and extremities

Journal article

Peer reviewed

Endovascular management of venous thrombotic diseases of the upper torso and extremities

Melhem J Sharafuddin, Shiliang Sun and Jamal J Hoballah

Journal of vascular and interventional radiology, Vol.13(10), pp.975-990

10/2002

DOI: 10.1016/S1051-0443(07)61861-2

PMID: 12397118

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Abstract

Central venous thrombosis in the upper torso can be either primary, occurring as a result of longstanding extrinsic compression, or secondary, resulting from an acquired intrinsic occlusive disease or foreign body. As in lower extremity deep vein thrombosis (DVT), anticoagulation therapy is the mainstay of therapy in upper torso and upper extremity DVT. However, in the presence of severely symptomatic acute thrombosis, pharmacologic and/or mechanical thrombolytic therapy represent the main invasive form of therapy for these conditions. After clearance of the acute thrombotic component, definitive management in patients with underlying anatomic abnormalities can be undertaken. Primary subclavian axillary vein thrombosis caused by extrinsic obstruction at the thoracic outlet is treated with thrombolytic therapy and anticoagulation followed by surgical decompression, whereas secondary causes of central venous obstruction and thrombosis are usually amenable to endovascular treatment with balloon angioplasty and stent placement. Postoperative interval anticoagulation is usually recommended. In addition to clinical follow-up, imaging follow-up with duplex sonography or conventional venography is usually recommended to assess the presence of restenosis and/or residual compression.

Radiography, Interventional

Venous Thrombosis - therapy

Humans

Venous Thrombosis - diagnostic imaging

Anticoagulants - therapeutic use

Superior Vena Cava Syndrome - therapy

Upper Extremity - blood supply

Venous Thrombosis - complications

Angiography, Digital Subtraction

Axillary Vein

Venous Thrombosis - etiology

Decompression, Surgical

Subclavian Vein

Thrombolytic Therapy

Superior Vena Cava Syndrome - etiology

Angioplasty, Balloon

Superior Vena Cava Syndrome - diagnostic imaging

Details

Title: Subtitle: Endovascular management of venous thrombotic diseases of the upper torso and extremities
Creators: Melhem J Sharafuddin - Department of Radiology, University of Iowa College of Medicine, 3889 JPP, 200 Hawkins Drive, Iowa City, Iowa 52242-1077, USA. mel-sharafuddin@uiowa.edu
Shiliang Sun
Jamal J Hoballah
Resource Type: Journal article
Publication Details: Journal of vascular and interventional radiology, Vol.13(10), pp.975-990
Publisher: United States
DOI: 10.1016/S1051-0443(07)61861-2
PMID: 12397118
ISSN: 1051-0443
eISSN: 1535-7732
Language: English
Date published: 10/2002
Academic Unit: Radiology; Surgery
Record Identifier: 9984051885002771

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