Role of thrombolytic therapy in axillary-subclavian vein thrombosis.

Axillary-subclavian vein thrombosis in young patients has produced long-term disability because of failure of the thrombosed vein to recanalize. In a review of 10 patients with axillary-subclavian vein thrombosis treated in our institution, four were effort vein thrombosis. All patients were diagnosed by venography. One patient received urokinase with complete resolution of symptoms and complete dissolution of the clot after two days of initial therapy, which was confirmed by venography and duplex imaging. Another patient received streptokinase with partial resolution of symptoms and dissolution of the clot, which was confirmed by venography. The other two patients were treated with conventional anticoagulant therapy with partial resolution of symptoms and no dissolution of the clot. Thrombolytic therapy appears to be superior to anticoagulation in dissolution of symptoms in effort vein thrombosis and should be considered in its management if the diagnosis is made early.