Safety and efficacy of early surgical decompression of the thoracic outlet for Paget-Schroetter syndrome

N. Angle, H. A. Gelabert, M. M. Farooq, S. S. Ahn, D. R. Caswell, J. A. Freischlag, H. I. Machleder

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Abstract

The surgical treatment of Paget-Schroetter syndrome has evolved to include early thrombolytic therapy and an interval period of anticoagulation, followed by late surgical decompression of the thoracic outlet. More recently, we have developed an abbreviated course of therapy in which the thrombolytic therapy is followed by early surgical decompression during the same admission, then a period of anticoagulation. We compared early surgical decompression with the standard management protocol to determine safety and efficacy of the early treatment algorithm. Nine patients were treated with lysis and early operation. These were compared with the preceding nine consecutive patients treated with lysis and staged operation. Demographic data, risk factors, duration of thrombosis, lytic therapy, time to surgery, operative variables, and postoperative complications were analyzed. Our results showed that thrombolysis followed by early operation does not result in increased perioperative morbidity or mortality. Early surgical decompression of the thoracic outlet during the same admission as lysis is as safe and efficacious as the traditional (staged decompression) approach to Paget-Schroetter syndrome. Lysis followed by early surgical decompression should be considered a new standard of care in the management of Paget-Schroetter syndrome.

Original languageEnglish (US)
Pages (from-to)37-42
Number of pages6
JournalAnnals of Vascular Surgery
Volume15
Issue number1
StatePublished - 2001

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Upper Extremity Deep Vein Thrombosis
Surgical Decompression
Thorax
Safety
Thrombolytic Therapy
Standard of Care
Secondary Prevention
Decompression
Thrombosis
Therapeutics
Demography
Morbidity
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Angle, N., Gelabert, H. A., Farooq, M. M., Ahn, S. S., Caswell, D. R., Freischlag, J. A., & Machleder, H. I. (2001). Safety and efficacy of early surgical decompression of the thoracic outlet for Paget-Schroetter syndrome. Annals of Vascular Surgery, 15(1), 37-42.

Safety and efficacy of early surgical decompression of the thoracic outlet for Paget-Schroetter syndrome. / Angle, N.; Gelabert, H. A.; Farooq, M. M.; Ahn, S. S.; Caswell, D. R.; Freischlag, J. A.; Machleder, H. I.

In: Annals of Vascular Surgery, Vol. 15, No. 1, 2001, p. 37-42.

Research output: Contribution to journalArticle

Angle, N, Gelabert, HA, Farooq, MM, Ahn, SS, Caswell, DR, Freischlag, JA & Machleder, HI 2001, 'Safety and efficacy of early surgical decompression of the thoracic outlet for Paget-Schroetter syndrome', Annals of Vascular Surgery, vol. 15, no. 1, pp. 37-42.
Angle N, Gelabert HA, Farooq MM, Ahn SS, Caswell DR, Freischlag JA et al. Safety and efficacy of early surgical decompression of the thoracic outlet for Paget-Schroetter syndrome. Annals of Vascular Surgery. 2001;15(1):37-42.
Angle, N. ; Gelabert, H. A. ; Farooq, M. M. ; Ahn, S. S. ; Caswell, D. R. ; Freischlag, J. A. ; Machleder, H. I. / Safety and efficacy of early surgical decompression of the thoracic outlet for Paget-Schroetter syndrome. In: Annals of Vascular Surgery. 2001 ; Vol. 15, No. 1. pp. 37-42.
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