Females with subclavian vein thrombosis may have an increased risk of hypercoagulability

Kendall Likes, Danielle Rochlin, Susanna M. Nazarian, Michael B. Streiff, Julie A. Freischlag

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Subclavian vein thrombosis (SVT) is usually caused by vigorous activity or extensive use of the upper extremity. Patients are tested for hypercoagulability if they present with a spontaneous clot unassociated with such activity. The objective of this study was to determine the prevalence of hypercoagulability in patients undergoing first rib resection and scalenectomy presenting with SVT. Methods: Using a prospectively maintained database from August 2003 through June 2011, patients were retrospectively reviewed for hypercoagulability testing and clinical outcomes. Results: One hundred forty-three patients (79 females and 64 males; mean [range] age, 32 [16-71] years) presented with SVT, of whom 55 patients (43 females and 12 males; mean age, 32 [16-61] years) had undergone hypercoagulable testing. Fourteen patients (25.5%) (12 females and 2 males; mean age, 27 [16-46] years) had an abnormal hypercoagulable profile. A factor V Leiden mutation was present in 6 patients, protein S deficiency in 4, a plasminogen-activator inhibitor-1 (PAI-1) deficiency in 2, and 1 patient each with protein C deficiency, anticardiolipin antibodies, factor VII mutation, factor II mutation, and antiphospholipid antibodies. Immediate and long-term postoperative vein patency was similar to patients without hypercoagulability. Patients were placed on lifelong anticoagulation therapy if they had a PAI-1, protein C, or protein S deficiency. Conclusions: Patients with hypercoagulability do as well with first rib resection and scalenectomy for SVT as those without hypercoagulability. In our patient subset, more females were tested owing to a history of spontaneous thrombosis and an increased incidence of hypercoagulable disorders. Because of our findings, we believe younger women with SVT should undergo hypercoagulable testing to identify the need for long-term anticoagulation therapy.

Original languageEnglish (US)
Pages (from-to)44-49
Number of pages6
JournalArchives of Surgery
Volume148
Issue number1
StatePublished - Jan 2013
Externally publishedYes

Fingerprint

Subclavian Vein
Thrombophilia
Thrombosis
Protein S Deficiency
Ribs
Mutation
Replication Protein C
Protein C Deficiency
Anticardiolipin Antibodies
Antiphospholipid Antibodies
Factor VII
Plasminogen Activator Inhibitor 1
Prothrombin
Protein C
Upper Extremity
Veins

ASJC Scopus subject areas

  • Surgery

Cite this

Likes, K., Rochlin, D., Nazarian, S. M., Streiff, M. B., & Freischlag, J. A. (2013). Females with subclavian vein thrombosis may have an increased risk of hypercoagulability. Archives of Surgery, 148(1), 44-49.

Females with subclavian vein thrombosis may have an increased risk of hypercoagulability. / Likes, Kendall; Rochlin, Danielle; Nazarian, Susanna M.; Streiff, Michael B.; Freischlag, Julie A.

In: Archives of Surgery, Vol. 148, No. 1, 01.2013, p. 44-49.

Research output: Contribution to journalArticle

Likes, K, Rochlin, D, Nazarian, SM, Streiff, MB & Freischlag, JA 2013, 'Females with subclavian vein thrombosis may have an increased risk of hypercoagulability', Archives of Surgery, vol. 148, no. 1, pp. 44-49.
Likes K, Rochlin D, Nazarian SM, Streiff MB, Freischlag JA. Females with subclavian vein thrombosis may have an increased risk of hypercoagulability. Archives of Surgery. 2013 Jan;148(1):44-49.
Likes, Kendall ; Rochlin, Danielle ; Nazarian, Susanna M. ; Streiff, Michael B. ; Freischlag, Julie A. / Females with subclavian vein thrombosis may have an increased risk of hypercoagulability. In: Archives of Surgery. 2013 ; Vol. 148, No. 1. pp. 44-49.
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abstract = "Background: Subclavian vein thrombosis (SVT) is usually caused by vigorous activity or extensive use of the upper extremity. Patients are tested for hypercoagulability if they present with a spontaneous clot unassociated with such activity. The objective of this study was to determine the prevalence of hypercoagulability in patients undergoing first rib resection and scalenectomy presenting with SVT. Methods: Using a prospectively maintained database from August 2003 through June 2011, patients were retrospectively reviewed for hypercoagulability testing and clinical outcomes. Results: One hundred forty-three patients (79 females and 64 males; mean [range] age, 32 [16-71] years) presented with SVT, of whom 55 patients (43 females and 12 males; mean age, 32 [16-61] years) had undergone hypercoagulable testing. Fourteen patients (25.5{\%}) (12 females and 2 males; mean age, 27 [16-46] years) had an abnormal hypercoagulable profile. A factor V Leiden mutation was present in 6 patients, protein S deficiency in 4, a plasminogen-activator inhibitor-1 (PAI-1) deficiency in 2, and 1 patient each with protein C deficiency, anticardiolipin antibodies, factor VII mutation, factor II mutation, and antiphospholipid antibodies. Immediate and long-term postoperative vein patency was similar to patients without hypercoagulability. Patients were placed on lifelong anticoagulation therapy if they had a PAI-1, protein C, or protein S deficiency. Conclusions: Patients with hypercoagulability do as well with first rib resection and scalenectomy for SVT as those without hypercoagulability. In our patient subset, more females were tested owing to a history of spontaneous thrombosis and an increased incidence of hypercoagulable disorders. Because of our findings, we believe younger women with SVT should undergo hypercoagulable testing to identify the need for long-term anticoagulation therapy.",
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