Modernizing the treatment of venous thoracic outlet syndrome

被引:14
作者
Bamford, Richard F. [1 ]
Holt, Peter J. E. [1 ]
Hinchliffe, Robert J. [1 ]
Thompson, Matt M. [1 ]
Loftus, Ian M. [1 ]
机构
[1] St Georges Healthcare NHS Trust, St Georges Vasc Inst, London SW17 0QT, England
关键词
Paget-Schroetter syndrome; deep vein thrombosis; first rib resection; thoracic outlet syndrome; effort thrombosis; PAGET-SCHROETTER-SYNDROME; SUBCLAVIAN VEIN-THROMBOSIS; EARLY OPERATIVE INTERVENTION; THROMBOLYTIC THERAPY; OBSTRUCTION; MANAGEMENT; AXILLARY; SURGERY;
D O I
10.1258/vasc.2011.oa0325
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
This study aims to quantify the management and outcomes of patients treated for venous thoracic outlet syndrome (vTOS) over a seven-year period. A retrospective case-note review of all patients undergoing first rib resection at a regional vascular unit between January 1, 2002 and December 31, 2009 was performed. Treatment pathways and outcomes recorded as freedom from symptoms and venous patency were analyzed. Thirty-five patients were identified with vTOS. Ninety-one percent of patients had patent veins at discharge from clinical follow-up and were symptom-free at a median of 44 months. Patients treated within seven days of symptoms (94.7 versus 85.7, P=0.060), with catheter-directed thrombolysis (94 versus 87.5% P=0.702) and excision of first rib in less than 30 days (100 versus 85.7%, P=0.002), had improved symptom-free rates. In conclusion, early referral, immediate catheter-directed thrombolysis, perioperative balloon venoplasty and early thoracic outlet decompression may provide a suitable model for improving outcomes in vTOS.
引用
收藏
页码:138 / 144
页数:7
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