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Thrombectomy in Lemierre's Syndrome: A Systematic Literature Review
Jevaughn Davis1, Crystal Adams1, Puneet Gupta2
1Department of Anesthesiology and Critical Care, George Washington School of Medicine and Health Sciences, Washington DC, USA.
Iranian Journal of Otorhinolaryngology
|April 20, 2026
Summary
Thrombectomy may offer clinical improvement for patients with treatment-resistant Lemierre's syndrome (LS), a rare septic thrombophlebitis. This procedure can potentially shorten intensive care unit and hospital stays for those unresponsive to standard antibiotic and anticoagulation therapies.
Area of Science:
- Infectious Diseases
- Vascular Surgery
- Critical Care Medicine
Background:
- Lemierre's syndrome (LS) is a rare, life-threatening condition involving septic thrombophlebitis of the internal jugular vein, often following oropharyngeal infections.
- While historically rare, LS has seen a resurgence due to increased awareness and evolving microbial resistance.
- Standard treatment with antibiotics and anticoagulation is effective for most, but a subset of patients requires prolonged therapy and experiences critical care admissions.
Purpose of the Study:
- To review the existing literature on the use of thrombectomy for treatment-resistant Lemierre's syndrome.
- To evaluate the potential role and outcomes of thrombectomy in patients with LS refractory to conventional treatments.
Main Methods:
- A comprehensive literature search was conducted using PubMed/MEDLINE and Scopus databases.
- Studies specifically investigating thrombectomy in the context of Lemierre's syndrome were identified and analyzed.
Main Results:
- Four relevant articles were identified, indicating limited but significant evidence.
- Patients undergoing thrombectomy for treatment-resistant LS generally showed clinical improvement.
- Average intensive care unit and hospital stays were reduced in patients treated with thrombectomy.
Conclusions:
- Thrombectomy for treatment-resistant Lemierre's syndrome is not extensively documented.
- However, thrombectomy presents a potential therapeutic option for select LS patients who do not respond to antibiotics and anticoagulation.
- While not universally indicated, it may offer a valuable alternative to historical treatments like vessel ligation.
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