Subclavian Vein Thrombosis: Background, Pathophysiology, Etiology V. subclavia Thrombophlebitis
Updated: Aug 03, The subclavian vein courses over the first just click for source and posterior to the clavicle; the artery lies superior and posterior to the vein see the image below. Sir James Paget first described thrombosis of the subclavian veins in Paget noted that the syndrome was accompanied by pain and swelling of the V. subclavia Thrombophlebitis extremity, but he incorrectly attributed the syndrome to vasospasm.
Invon Schrötter postulated that this syndrome resulted from occlusive thrombosis of the subclavian and axillary veins. The incidence of this V. subclavia Thrombophlebitis has increased remarkably over the past two decades because of the extensive use of central venous catheters in patients with cancer and other chronic medical conditions.
The demand for a more standardized treatment of subclavian vein thrombosis is growing. However, until randomized data from well-designed trials are available, absolute statements about treatments cannot be made. Linked click records using administrative healthcare V.
subclavia Thrombophlebitis sets may provide information ie, readmission rate or level of outpatient services V. subclavia Thrombophlebitis the results of treatment of large numbers of patients with subclavian vein thrombosis or significant risk factors such as central venous cannulation. Until such information is obtained, the best way of treating subclavian vein thrombosis is to prevent link by limiting the use of central venous catheters for extended periods.
For patient education resources, see Phlebitis. During long-term venous catheterization of the subclavian vein and internal jugular vein in cancer patients, the risks of complications appear to be similar. However, for short-term catheterization, subclavian vein catheterization is recommended because of the decreased risks of thrombotic complications and V. subclavia Thrombophlebitis colonization by skin flora. For patients requiring hemodialysis, the femoral and internal jugular veins appear to have similar thrombotic complications.
However, the V. subclavia Thrombophlebitis of mechanical complications via the internal jugular vein appear to be higher. The subclavian vein should be avoided for both long- magnetische und Krampfadern short-term hemodialysis because the risk of thrombosis is very high.
This syndrome sometimes is referred to as spontaneous axillary-subclavian vein thrombosis ASVT to express the usually dramatic unexpected presentation of the disorder in otherwise healthy, generally young individuals. In the s, the term effort-induced thrombosis was applied V. subclavia Thrombophlebitis this disease to acknowledge that it often follows unusually strenuous use of the arm or shoulder on the affected side.
The pathophysiology of effort-induced thrombosis is multifactorial. It involves compressive changes in the vessel wall, stasis of blood, and hypercoagulability. External compression of the axillary-subclavian vein has been suggested to contribute to the stasis of blood that engenders thrombosis. The factors that cause external compression include the following: These factors, taken together, satisfy the classic Virchow triad for thrombosis.
Furthermore, coexistent hematologic abnormalities that can contribute to thrombosis include protein C deficiency, antithrombin III deficiency, factor V Leiden mutation, source prothrombin A mutation. Introducing V. subclavia Thrombophlebitis and transvenous pacemakers in to the subclavian vein alters the venous flow and increases turbulence.
This results in platelet aggregation, release of procoagulants, and, ultimately, fibrin deposition. This causes a further reduction in the lumen of the vessel due to thrombus formation, which eventually culminates in total vessel occlusion.
Intravenous IV medications and even parenteral nutrition have been known to cause thrombophlebitis. In patients with cancer, an additional contributing factor is that the tumor may generate procoagulant factors, predisposing to thrombosis at sites remote from the tumor. The primary etiology is referred to as effort-induced thrombosis or Paget—von Schrötter syndrome. It usually results from the excessive use of the involved arm by predisposed individuals.
The secondary etiology is subclavian vein catheterization, especially in patients with cancer. For detailed descriptions of catheterization techniques, see Central Venous Access, Subclavian Vein, Subclavian Approach and Central Venous Access, Subclavian Vein, V.
subclavia Thrombophlebitis Approach. Other causes include transvenous pacemakersfactor V Leiden mutation, protein C deficiencyprotein S deficiencyantithrombin III deficiencyand prothrombin A mutation. Trauma is only rarely associated with this syndrome. In continue reading few cases, the diagnosis remains unknown. However, routine follow-up with these patients has revealed the development of lung cancer V.
subclavia Thrombophlebitis 1 year of follow-up. The most common lung malignancy associated with subclavian thrombosis has been the Pancoast tumor. Since then, the incidence has risen as a consequence of more frequent use of central venous access for multiple clinical conditions.
The long-term consequences of venous occlusion cause substantial morbidity related to persistent pain and swelling for protracted periods of time. These symptoms occasionally are severe and can be visit web page by physical activity, particularly with extended use of the affected arm. V.
subclavia Thrombophlebitis, this syndrome can lead to occupational disability and can adversely impact the patient's quality of life. V. subclavia Thrombophlebitis treatment consisting of V. subclavia Thrombophlebitis rest, limb elevation, and anticoagulation is associated with a worse outcome. With advances in endovascular technology, there is more supporting evidence that these techniques are the modality of choice when encountering a patient with upper-extremity thrombosis.
Anticoagulation or thrombolytic therapy alone has proved inadequate. Today, V. subclavia Thrombophlebitis benign and malignant causes of upper-extremity thrombosis can be V. subclavia Thrombophlebitis with endovascular stenting. This technique allows much faster recovery while giving rise to less morbidity and fewer complications in the long V. subclavia Thrombophlebitis. Nothragel Handbuch der pathologie and therapie.
Vienna, Austria: Holder; Venous obstruction V. subclavia Thrombophlebitis the upper extremity Paget-Schroetter Syndrome. Ge X, Cavallazzi R, Li C, et al. Central venous access sites for the prevention of venous thrombosis, stenosis and infection. Cochrane Database Syst Rev. Berea-Baltierra R, Rivas-Ruiz R, Vela-Martinez E, Sevilla-Gonzalez Mde L, Talavera-Pina JO, Valencia-Jimenez E, et al.
Risk factors for subclavian vein thrombosis in cancer patients with total parenteral nutrition. J Clin Med Res. Subclavian vein dialysis access catheter-complications are low. Nepal Med Coll J. Margey R, Schainfeld RM. Upper Extremity Deep Vein Thrombosis: The Oft-forgotten Cousin of Venous Thromboembolic Disease.
Curr Treat Options Cardiovasc Med. Bosma J, Vahl AC, Coveliers HM, Rauwerda JA, Wisselink W. Primary subclavian vein thrombosis this web page its long-term effect on quality of life. Levy MM, Albuquerque F, Pfeifer JD. Low incidence of pulmonary embolism associated with V. subclavia Thrombophlebitis deep venous thrombosis. Philadelphia, Pa: WB Saunders; Aburahma AF, Sadler D, Stuart P.
Role of thrombolytic therapy in axillary-subclavian vein thrombosis. Aburahma AF, Sadler DL, Robinson PA. Axillary subclavian vein thrombosis. Changing patterns of etiology, diagnostic, and therapeutic V.
subclavia Thrombophlebitis. Anderson AJ, Krasnow SH, Boyer MW. Thrombosis: the major Hickman catheter complication in patients with solid tumor. Becker DM, Philbrick JT, Walker FB 4th. Axillary and V. subclavia Thrombophlebitis venous thrombosis. Becker V.
subclavia Thrombophlebitis, Holden RW, Rabe FE. Local thrombolytic therapy for subclavian and axillary vein thrombosis.
Treatment of the thoracic inlet syndrome. Bern MM, V. subclavia Thrombophlebitis A Jr, Bistrian B. Prophylaxis against central vein thrombosis with low-dose warfarin. Bern MM, Lokich JJ, Wallach SR.
Very low doses of warfarin can prevent thrombosis in central venous catheters. A randomized prospective trial. Bottino J, McCredie KB, Groschel DH. Long-term intravenous therapy with peripherally inserted silicone elastomer central venous catheters in patients with malignant diseases.
Campbell CB, Chandler JG, Tegtmeyer CJ. Axillary, subclavian, and brachiocephalic vein obstruction. Coon WW, Willis PW 3d. Thrombosis of axillary and subclavian veins. Thrombosis of the deep veins of the arm. Dellinger RP, Savage PJ. Axillary vein thrombosis simulating superior vena cava syndrome. Drapanas T, Curran WL. Thrombectomy in the treatment of "effort" thrombosis of the axillary and subclavian veins. Gagne PJ, Martinez JM. Treatment of upper extremity phlegmasia cerulea dolens with intraarterial thrombolytics.
Goldhaber SZ, Hennekens CH. Time trends in hospital mortality and diagnosis of pulmonary embolism. Haire WD, Lynch TG, Lieberman RP. Utility of duplex ultrasound in the diagnosis of asymptomatic catheter- induced subclavian vein thrombosis. Haire WD, Lynch TG, Lund V. subclavia Thrombophlebitis. Limitations of magnetic resonance imaging and ultrasound-directed duplex scanning in the diagnosis of subclavian vein thrombosis.
Lee MC, Grassi CJ, Belkin M. Early operative intervention after thrombolytic therapy for primary subclavian vein thrombosis: an effective treatment approach. Lokich JJ, Bothe A Jr, Benotti P. Complications and management of implanted venous access catheters. Primary thrombosis of the axillary vein caused by strain. Ochsner A, Debakey ME, Decamp RT. Thromboembolism-analysis of cases at Charity Hospital in New Orleans over a Krampfadern der unteren Extremitäten Grad 3 Foto period.
Congenital anomalies associated with thoracic outlet syndrome. Anatomy, symptoms, diagnosis, and treatment. Ross AH, Griffith CD, Anderson JR. Thromboembolic complications with silicone elastomer subclavian catheters. JPEN J Parenter Enteral Nutr. Inhibition of intravascular fibrinolytic activation by trauma. Taylor LM Jr, McAllister WR, Dennis DL. Thrombolytic therapy followed by first rib resection for spontaneous "effort" subclavian vein thrombosis.
Challenges in the treatment of thoracic outlet syndrome. Tex Heart Inst J. Comprehensive management of subclavian vein effort thrombosis. Tilney ML, Griffiths HJ, Edwards EA. Natural history of major venous thrombosis of the upper extremity. Zimmermann R, Morl H, Harenberg J. Urokinase therapy of subclavian-axillary vein thrombosis.
Log In Sign Up It's Free! Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. This figure shows the area where the subclavian vein is obstructed in the neck area. The vein is usually compressed by the first rib, clavicle, and serratus anterior muscle. Anomalous subclavius or scalenus anterior, long transverse process of cervical spine, cervical rib, abnormal insertion of the V.
subclavia Thrombophlebitis rib, congenital fibromuscular bands, or narrowing of the costoclavicular space from depression of the shoulder. Repetitive shoulder-arm motion causing microscopic intimal tears in the vessel wall. Clinical Lectures and Essays. London, UK: Longmans Green and Co; A venogram in a patient with subclavian vein obstruction. Long-standing obstruction causes development of collaterals.
Recanalization after thrombolytic therapy and stent placement. Patient underwent first rib resection and scalenectomy later. What would you like to print?
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V. subclavia Thrombophlebitis
Axillo-subclavian vein thrombosis, also called Paget-Schroetter Syndrome, is a rare medical condition in the general population. But, it is the one of the most common vascular conditions to affect young, competitive athletes. The condition develops when a vein in the armpit the axilla or in the front of the shoulder the subclavian vein is compressed by the collarbone claviclethe first rib, or the surrounding muscle.
It is considered a type of thoracic outlet syndrome. As welches Medikament wird am besten genommen person uses his or her arm repeatedly and the axillo-subclavian vein is compressed, the vein becomes inflamed. Over time, fibrous tissue builds up in the vein. The inside of the vein eventually becomes too narrow to allow normal blood flow.
As a result, a blood clot forms. Axillo-subclavian vein thrombosis can occur in people who repeatedly use their arm in a raised position. Call for Additional V. subclavia Thrombophlebitis. Chat with a Heart Nurse. What is axillo-subclavian vein thrombosis? Who is at risk for axillo-subclavian vein thrombosis? Young athletes who participate in sports that involve heavy use of the upper arms, such baseball players especially pitchersbasketball players, swimmers, V.
subclavia Thrombophlebitis players and weight lifters. People whose work involves V. subclavia Thrombophlebitis use of the upper arm, such as house painters or window washers. Other people at risk include those who have:. A central venous catheter in the subclavian vein for an extended time, such as for chemotherapy or hemodialysis. A pacemaker or defibrillator, because the wires http://newohioreview.com/blog/trophischen-geschwueren-patch.php through the thoracic outlet.
A blood clotting disorder. Blood Clotting Disorders - Hypercoagulable States. Deep Vein Thrombosis - DVT. Call V. subclavia Thrombophlebitis at Appointments Pay Your Bill Financial Assistance Accepted see more Make a Donation Refer a Patient Phone Directory.
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- Tinktur aus Kastanien Rezept Varizen
Syndrome of Paget-Schröetter (thrombosis) of v. subclavia. Vlahov K, Baldzijski A. PMID: [PubMed - indexed for MEDLINE] Thrombophlebitis /diagnosis*.
- wie Prellungen von Krampfadern zu behandeln
Clinical Practice from The New England Journal of Medicine — Deep-Vein Thrombosis of the Upper Extremities. () Thrombose der V. subclavia bei konservativ.
- Femoston Varizen
Primary, "spontaneous" upper extremity deep vein thrombosis is rare and is defined as thrombosis of the deep veins draining the upper extremity due to anatomic.
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Lungenembolie mit Lungeninfarkt als Folge einer Thrombophlebitis der V. cephalica proximale Anteil der Thrombo- V. basilica V. axillaris V. subclavia V. brachio-.
- Salbe trophic Ulkusbehandlung
Primary, "spontaneous" upper extremity deep vein thrombosis is rare and is defined as thrombosis of the deep veins draining the upper extremity due to anatomic.
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