Spontaneous subclavian vein thrombosis: a successful combined approach of local thrombolytic therapy followed by first-rib resection.

In 17% to 74% of patients with subclavian vein thrombosis, conservative treatment or venous thrombectomy led to residual symptoms. To improve these results, a prospective study was started in patients with subclavian vein thrombosis who were treated with a combined approach of local thrombolytic therapy followed by a first-rib resection. From 1983 to 1987 five patients entered the protocol. Total lysis was achieved in all cases. In the follow-up period, phlebography and strain-gauge plethysmography according to Whitney showed no recurrent thrombosis. All patients were able to resume their normal activities.