Original article: general thoracicPaget-Schroetter syndrome therapy: failure of intravenous stents
Section snippets
Patients
Twenty-two patients with PSS diagnosis, less than 6 weeks from initial thrombosis, received thrombolytics, venous balloon angioplasty, and intravenous stent placement. These were seen during a period of 8 years. There were 12 men and 10 women ranging in age from 17 to 42 years (mean, 29 years). All patients had stents placed in outside hospitals. There was no standardized indication for stent implantation, because the patients were referred from a number of different physicians and hospitals
Results
All 22 of the stent patients had thrombosis of the venous stents within 6 weeks of placement and were referred to our hospital. The 22 patients were retreated with the rethrombolysis protocol followed promptly by surgical decompression of the vein. Ten extremities were reopened and 12 remained occluded. Mean follow-up of 3.5 years (range, 1 to 8 years) showed 10 patients had patent veins. Of the other 12 patients with occluded veins, 7 developed good collateral circulation and were
Comment
Historically, Sir James Paget [17] in 1875 in London and Von-Schroetter [18] in 1884 in Vienna described this syndrome of thrombosis of the axillary-subclavian vein, which bears their names. The word “effort” [19] was added to thrombosis because of the frequent association with exertion superimposed on anatomic compressive elements in the thoracic outlet. Trauma, unusual occupations requiring repetitive muscular activity, as has been observed in professional athletes, linotype operators,
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