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Controversies in VTOS: How Long Should Anticoagulation Be Used in VTOS?

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Thoracic Outlet Syndrome

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Abstract

Anticoagulation is an important element in the management of most patients with VTOS. The use of anticoagulation should be tailored to the specific form of VTOS present, however, and modified according to the condition of the individual patient. In general, patients with non-thormbotic positional venous compression requires no anticoagulation. Those with acute axillosubclavian vein thrombosis require anticoagulation to prevent propagation of thrombus, reduce the risk of pulmonary embolus, and to reduce the risk of rethrombosis while awaiting decompression, and following this should be anticoagulated for 3 months. Patients with chronic venous occlusion do not require anticoagulation for safety, but long-term anticoagulation may be associated with spontaneous recanalization and thus can be considered.

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References

  1. Marks J. Anticoagulant therapy in the idiopathic ­occlusion of the axillary vein. Br Med J. 1956;1(4957):11–3.

    Article  PubMed  CAS  Google Scholar 

  2. Marks J, Truscott BM, Withycombe JF. Treatment of venous thrombosis with anticoagulants; review of 1135 cases. Lancet. 1954;267(6842):787–91.

    Article  PubMed  CAS  Google Scholar 

  3. Adams JT, De Weese JA. Effort thrombosis of the axillary and subclavian veins. J Trauma. 1971;11:923–30.

    Article  PubMed  CAS  Google Scholar 

  4. Tilney NL, Griffiths HJG, Edwards EA. Natural history of major venous thrombosis of the upper extremity. Arch Surg. 1970;101:792–6.

    Article  PubMed  CAS  Google Scholar 

  5. Machleder HI. Evaluation of a new treatment strategy for Paget-Schroetter syndrome: spontaneous thrombosis of the axillary-subclavian vein. J Vasc Surg. 1993;17(2):305–15; discussion 316–7.

    Article  PubMed  CAS  Google Scholar 

  6. Kooij JD, van der Zant FM, van Beek EJ, Reekers JA. Pulmonary embolism in deep venous thrombosis of the upper extremity: more often in catheter-related thrombosis. Neth J Med. 1997;50(6):238–42.

    Article  PubMed  CAS  Google Scholar 

  7. Monreal M, Lafoz E, Ruiz J, Valls R, Alastrue A. Upper-extremity deep venous thrombosis and pulmonary embolism. A prospective study. Chest. 1991;99(2):280–3.

    Article  PubMed  CAS  Google Scholar 

  8. Kearon C, Kahn SR, Agnelli G, Goldhaber SZ, Raskob G, Comerota AJ. Antithrombotic therapy for venous thromboembolic disease: ACCP evidence-based clinical practice guidelines (8th edition). Chest. 2008;133:454S–545.

    Article  PubMed  CAS  Google Scholar 

  9. Kunkel JM, Machleder HI. Treatment of Paget-Schroetter syndrome. A staged, multidisciplinary approach. Arch Surg. 1989;124(10):1153–7; discussion 1157–8.

    Article  PubMed  CAS  Google Scholar 

  10. Angle N, Gelabert HA, Farooq MM, Ahn SS, Caswell DR, Freischlag JA, Machleder HI. Safety and efficacy of early surgical decompression of the thoracic outlet for Paget-Schroetter syndrome. Ann Vasc Surg. 2001;15(1):37–42.

    PubMed  CAS  Google Scholar 

  11. Vayá A, Mira Y, Mateo J, Falco C, Villa P, Estelles A, Corella D, Fontcuberta J, Aznar J. Prothrombin G20210A mutation and oral contraceptive use increase upper-extremity deep vein thrombotic risk. Thromb Haemost. 2003;89(3):452–7.

    PubMed  Google Scholar 

  12. Martinelli I, Battaglioli T, Bucciarelli P, Passamonti SM, Mannucci PM. Risk factors and recurrence rate of primary deep vein thrombosis of the upper extremities. Circulation. 2004;110(5):566–70. Epub 2004 Jul 19.

    Article  PubMed  Google Scholar 

  13. Héron E, Lozinguez O, Alhenc-Gelas M, Emmerich J, Fiessinger JN. Hypercoagulable states in primary upper-extremity deep vein thrombosis. Arch Intern Med. 2000;160(3):382–6.

    Article  PubMed  Google Scholar 

  14. Cassada DC, Lipscomb AL, Stevens SL, Freeman MB, Grandas OH, Goldman MH. The importance of thrombophilia in the treatment of Paget-Schroetter syndrome. Ann Vasc Surg. 2006;20:596–601.

    Article  PubMed  Google Scholar 

  15. Schneider DB, Dimuzio PJ, Martin ND, Gordon RL, Wilson MW, Laberge JM, Kerlan RK, Eichler CM, Messina LM. Combination treatment of venous thoracic outlet syndrome: open surgical decompression and intraoperative angioplasty. J Vasc Surg. 2004;40(4):599–603.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Vascular Surgery, Vascular Surgery Division, UCLA David Geffen School of Medicine, 200 UCLA Medical Plaza, Ste 526, Los Angeles, CA, 90095-6904, USA

    Hugh A. Gelabert MD

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  1. Hugh A. Gelabert MD
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Correspondence to Hugh A. Gelabert MD .

Editor information

Editors and Affiliations

  1. , Division of Vascular Surgery, University of South Florida, Tampa General Circle, STC 7016 2, Tampa, 33606, Florida, USA

    Karl A. Illig

  2. Barnes-Jewish Hospital, Department of Surgery, Washington University, Queeny Tower Campus Box, St. Louis, 63110, Missouri, USA

    Robert W. Thompson

  3. , Department of Surgery, John Hopkins Medical Institutions, Rutland Avenue - Ross 759 729, Baltimore, 21205, Maryland, USA

    Julie Ann Freischlag

  4. , Department of Thoracic Surgery, Blake 15, Massachusetts General Hospital, Fruit Street 55, Boston, 02114, Massachusetts, USA

    Dean M. Donahue

  5. Neurological Associates of West LA, Wilshire Blvd, Suite 790 2811, Santa Monica, 90403, California, USA

    Sheldon E. Jordan

  6. , Graduate Program in Physical Therapy, UCSF/SFSU, Balmoral Street 2429, Union City, 94587, California, USA

    Peter I. Edgelow

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© 2013 Springer-Verlag London

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Gelabert, H.A. (2013). Controversies in VTOS: How Long Should Anticoagulation Be Used in VTOS?. In: Illig, K., Thompson, R., Freischlag, J., Donahue, D., Jordan, S., Edgelow, P. (eds) Thoracic Outlet Syndrome. Springer, London. https://doi.org/10.1007/978-1-4471-4366-6_75

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  • DOI: https://doi.org/10.1007/978-1-4471-4366-6_75

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4365-9

  • Online ISBN: 978-1-4471-4366-6

  • eBook Packages: MedicineMedicine (R0)

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