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Axillary, subclavian, and brachiocephalic vein obstruction
Surgery
|December 1, 1977
Summary
Major upper extremity vein occlusion can lead to chronic swelling and pain. Morbidity depends on the cause, with intimal injury thrombosis causing fewer symptoms than effort thrombosis or extrinsic compression.
Area of Science:
- Vascular Surgery
- Venous Thrombosis
- Upper Extremity Disorders
Background:
- Occlusion of major upper extremity veins presents diverse clinical scenarios.
- Understanding long-term consequences and treatment efficacy is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the consequences of major upper extremity vein occlusion.
- To assess the impact of etiology and treatment on chronic morbidity.
Main Methods:
- Retrospective follow-up of 25 patients with vein occlusion (effort thrombosis, intimal injury, extrinsic compression, hypercoagulable).
- Diagnostic venography and noninvasive hemodynamic studies were utilized.
- Treatment included anticoagulants and operative intervention (removal/bypass).
Main Results:
- Venography confirmed diagnosis but limited proximal extent definition.
- Noninvasive studies aided therapy assessment but didn't always correlate with chronic morbidity.
- Chronic morbidity varied by etiology: intimal injury had minimal symptoms, effort thrombosis had intermediate symptoms, and extrinsic compression led to significant symptoms.
- Operative treatment improved venous outflow but symptom relief was inconsistent, especially for extrinsic compression.
Conclusions:
- Chronic morbidity following upper extremity vein occlusion is primarily determined by the underlying etiology.
- Anticoagulant and operative treatments showed variable success in alleviating long-term symptoms.
- Extrinsic compression poses significant challenges for symptom management despite improved venous outflow.