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J Orthop Surg (Hong Kong) 2019 Jan-Apr;27(1):2309499019832728

Department of Emergent Trauma Surgery, Qilu Hospital, Shandong University, Jinan, Shandong, People's Republic of China.

Deep vein thrombosis and pulmonary embolism, collectively referred to as venous thromboembolism, constitute a major global burden of disease. Although deep vein thrombosis in the upper extremity is less common than lower extremity, it has been associated with similar adverse consequences. We have had experienced with one case of subclavian vein thrombosis and fatal pulmonary embolism after proximal humeral fracture surgery. Read More

Medicine (Baltimore) 2019 Mar;98(9):e14622

Department of Gastroenterology, Jiangsu Province Hospital of Chinese Medicine (Affiliated Hospital of Nanjing University of Chinese Medicine), Nanjing, China.

Rationale: Inflammatory bowel disease (IBD), including Crohn disease (CD) and ulcerative colitis (UC), is characterized by chronic inflammatory condition and immunological abnormalities, which probably develop into venous thromboembolic events (VTEs). VTE in IBD patients mostly occurs at deep venous thrombosis (DVT) and pulmonary embolism (PE). The complications are extremely important in clinical practice considering the high mortality rate. Read More

Catheter Cardiovasc Interv 2019 Feb 9. Epub 2019 Feb 9.

Department of Pediatric Cardiology, University Hospital Tuebingen, Tuebingen, Germany.

Objectives: To describe the efficacy and safety of stent-retriever thrombectomy in infants with thrombosis of the superior vena cava (SVC) and innominate vein.

Background: Thrombosis of the SVC and of the innominate vein is a potentially life threatening complication in infants during intensive care treatment following major surgical procedures. To avoid reoperations, we evaluated interventional revascularization by stent-retriever thrombectomy. Read More

Rev Esp Anestesiol Reanim 2019 Feb 1. Epub 2019 Feb 1.

Universidad Nacional de Colombia, Bogotá DC, Colombia; Fundación Hospital Pediátrico de la Misericordia, Bogotá DC, Colombia.

The insertion of a central venous catheter is a procedure frequently performed in paediatric anaesthesia. The most frequent approach for this procedure is the internal jugular vein. However, some specific factors in children, such as the short neck and the easy collapse of this vein, which is accentuated in situations such as hypovolaemia and changes in the respiratory pattern, can lead to greater difficulty. Read More

Microsurgery 2019 Jan 28. Epub 2019 Jan 28.

Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.

Abdominal free flaps such as the muscle sparing transverse rectus abdominis myocutaneous (ms-TRAM) or deep inferior epigastric artery perforator (DIEP) flap represent the gold standard in autologous breast reconstruction. We describe a salvage procedure during bilateral free flap breast reconstruction due to insufficient venous drainage using a venous cross-over bypass. A 54-year-old woman with a thrombosis of the left subclavian port-system in the medical history was elected for simultaneous bilateral breast reconstruction with ms-TRAM and DIEP flaps. Read More

J Ultrasound Med 2019 Jan 28. Epub 2019 Jan 28.

Department of Intervention, Second Affiliated Hospital of Soochow University, Suzhou, China.

Objectives: To compare ultrasound-guided right brachiocephalic vein (BCV) central venous catheter (CVC) placement to right subclavian vein (SCV) CVC insertion in terms of the puncture success rate and complications.

Methods: A retrospective review was performed for all adult patients who received an ultrasound-guided CVC via the right BCV or right SCV access route between January 2016 and March 2018. The puncture success rates and procedure-related complications were analyzed. Read More

J Pediatr Surg 2018 Dec 27. Epub 2018 Dec 27.

Department of Pediatric Surgery, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO; Department of Surgery, Denver Health Medical Center, Denver, CO.

Background: Central venous catheters (CVC) are vital to the management of critically ill children. Despite efforts to minimize complications, central line associated bloodstream infection (CLABSI) and venous thromboembolisms (VTE) still occur.

Methods: We performed a retrospective review of a prospectively collected database for children admitted to the pediatric intensive care unit (PICU) between November 2013 and December 2016. Read More

J Emerg Med 2019 Jan 8. Epub 2019 Jan 8.

Temple University Hospital, Philadelphia, Pennsylvania.

Background: Internal jugular venous thrombosis (IJVT) is an uncommon condition rarely diagnosed in the outpatient setting. IJVT carries significant morbidity and mortality and must be considered in the differential diagnosis for new-onset neck pain and swelling, especially in the emergency setting. Paget-Schroetter syndrome (PSS), or primary thrombosis secondary to effort, is an uncommon, likely under-recognized etiology of thrombosis. Read More

J Tehran Heart Cent 2018 Apr;13(2):73-75

Cardiology Department, East Surrey Hospital, Redhill, UK.

Upper limb deep vein thrombosis (DVT) is a less common phenomenon than lower limb DVT. Repeated trauma secondary to sport- or job-related arm movements and positions has been recognized as the predisposing factor for upper limb DVT. We describe a 38-year-old male computer programmer admitted with swelling and pain in his left upper limb. Read More

J Vasc Surg Venous Lymphat Disord 2019 Jan 12;7(1):106-112.e3. Epub 2018 Nov 12.

Division of Vascular and Endovascular Surgery, USF Health Morsani College of Medicine, Tampa, Fla.

Background: Subclavian vein stenosis or occlusion at the thoracic outlet is a problem associated with certain anatomic and environmental stresses (venous thoracic outlet syndrome [VTOS]), the presence of central venous catheters, and the high flows associated with arteriovenous (AV) access in the limb. We describe our experience with open and endovascular techniques for restoring patency in highly symptomatic patients.

Methods: A prospectively collected database of patients was queried for patients treated for central venous obstructive disease in the setting of highly symptomatic VTOS and ipsilateral AV access from October 2011 to August 2016. Read More

Methodist Debakey Cardiovasc J 2018 Jul-Sep;14(3):214-218

GUY'S AND ST THOMAS' NHS TRUST, LONDON, ENGLAND.

Central vein thrombosis is defined as thrombosis of the major vessels draining either the upper or lower extremities. It presents most commonly in the upper limb, where it affects the subclavian veins and the superior vena cava; in the lower limb, it affects the common iliac veins and the inferior vena cava. These different anatomical segments pose unique challenges in both acute and chronic settings, and this article will summarize the current best practice treatment options. Read More

Nucl Med Mol Imaging 2018 Oct 20;52(5):398-400. Epub 2018 Aug 20.

1Nuclear Medicine Department, Montpellier University Hospital, Montpellier, France.

Baseline F-FDG PET was performed in a 74-year-old patient with relapsing upper mediastinum lymphoma. Left subclavian thrombosis was suspected on prior contrast-enhanced CT. Dynamic PET imaging was achieved during 3 min after IV injection of F-FDG to the left arm in order to further assess left subclavian vein permeability. Read More

Med J Aust 2018 Oct;209(8):335-336

Northeast Health Wangaratta, Wangaratta, VIC.

Medicina (B Aires) 2018 ;78(5):372-375

Servicio de Clínica Médica, Hospital Británico de Buenos Aires, Argentina. E-mail:

Deep vein thrombosis (DVT) of the upper limb is a rare entity, estimated to account for 10% of all cases of DVT. Classically, they are classified into primary (idiopathic, due to subclavian vein compression or exercise related) and secondary (cancer, thrombophilia, trauma, shoulder surgery, associated to venous catheters or due to hormonal causes). The Paget- Schrötter syndrome is a primary thrombosis of the subclavian vein in the subclavian-axillary junction, related either to repetitive movements or to exercise; leading to microtrauma in the endothelium with consequent activation of the coagulation cascade. Read More

J Cardiol Cases 2018 Oct 23;18(4):149-151. Epub 2018 Jul 23.

Department of Emergency Medicine, Hiroshima Citizens Hospital, Hiroshima, Japan.

Pregnancy is well-known risk factor for deep vein thrombosis (DVT), which usually occurs during the third trimester and in the left-sided lower extremity. We present a case of left subclavian and right femoral vein thrombosis in a pregnant woman with a gestational age of 10 weeks. A 39-year-old woman visited the emergency department complaining of acute pain and swelling of the left upper arm and right lower extremity. Read More

J Cardiol Cases 2018 Jan 1;17(1):9-11. Epub 2017 Sep 1.

Division of Cardiovascular Medicine, Department of Internal Medicine, Wanfang Hospital Taipei Medical University, Taipei, Taiwan.

Thrombosis involving the subclavian vein and superior vena cava is relatively common, especially in cancer patients. Edema of the arms and head is a well-known clinical consequence of this thrombosis. The intrinsic risk of pulmonary embolism has not been reported previously. Read More

J Intensive Care Med 2018 Sep 19:885066618795126. Epub 2018 Sep 19.

4 Department of General Surgery, Medstar Georgetown University Hospital, Washington, DC, USA.

Background: Central venous catheter (CVC) complication rates reflecting the application of modern insertion techniques to a clinically heterogeneous patient populations are needed to better understand procedural risk attributable to the 3 common anatomic insertion sites: internal jugular, subclavian, and femoral veins. We sought to define site-specific mechanical and duration-associated CVC complication rates across all hospital inpatients.

Methods: A retrospective chart review was conducted over 9 months at Georgetown University Hospital and Washington Hospital Center. Read More

Ann Vasc Surg 2019 Jan 11;54:118-122. Epub 2018 Sep 11.

Yale University, Division of Vascular Surgery, Department of General Surgery, New Haven, CT.

Background: Venous thoracic outlet syndrome (vTOS) is a rare disease with no defined guidelines regarding treatment. Patients with first rib resection with anterior scalenectomy (FRRS) often have residual subclavian vein stenosis. The aim of this study was to evaluate the use of intravascular ultrasound (IVUS) in the treatment of vTOS patients who have been surgically decompressed with FRRS. Read More

Clin Appl Thromb Hemost 2018 Nov 19;24(8):1234-1240. Epub 2018 Jul 19.

4 Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan.

Patients with cancer have an increased risk of venous thromboembolism. Upper extremity venous system is a peculiar site, and little is known about the clinical course in patients with cancer. Electronic medical records were searched for patients with cancer with a diagnosis of upper extremity venous thrombosis. Read More

Int J Surg Case Rep 2018 20;49:81-86. Epub 2018 Jun 20.

Department of Orthopaedics, Sengkang General Hospital, Singapore. Electronic address:

Background: Paget-Schrotter Syndrome (PSS) also known as "effort thrombosis" is a form of primary thrombosis in the subclavian vein at the costoclavicular junction is usually seen in younger patients after repeated strenuous activity of the shoulders and arms. When occurring in younger patients, PSS presents itself with predisposing factors such as unilateral dull, aching pain in the shoulder or axilla and swelling of the arm and hand.

Case Presentation: We report a rare case of unusual left axillo-subclavian vein thrombosis following narrowing of thoracic outlet due to stress injury of rib fracture likely during gym activity in absence of other clear risk factors and a negative hypercoagulable workup in a 27-year-old man who was admitted as left deltoid rupture 5 days after his usual gym. Read More

BMJ Case Rep 2018 Jun 28;2018. Epub 2018 Jun 28.

Department of Vascular and Endovascular Surgery, Barwon Health, Geelong, Victoria, Australia.

Subclavian artery injury is a rare consequence of clavicle fracture. It most often results from penetrating trauma but can result from blunt trauma with adjacent bone fragments causing rupture, pseudoaneurysm, dissection or thrombosis of the artery. If flow through the subclavian artery is compromised there is a risk of ipsilateral upper limb ischaemia. Read More

J Vasc Access 2019 Mar 20;20(2):134-139. Epub 2018 Jun 20.

Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.

Purpose:: To evaluate the clinical outcomes and complications of totally implantable venous access port implantation via the axillary vein in patients with head and neck malignancy.

Materials And Methods:: A total of 176 totally implantable venous access ports were placed via the axillary vein in 171 patients with head and neck malignancy between May 2012 and June 2015. The patients included 133 men and 38 women, and the mean age was 58. Read More

Rev Bras Ortop 2018 Mar-Apr;53(2):171-175. Epub 2018 Feb 15.

Centro de Traumatologia do Esporte, Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Objective: To assess the results of the treatment of fractures of the middle third of the clavicle with a pre-contoured plate in athletes.

Methods: The authors performed 26 osteosyntheseis in 25 patients with fractures of the middle third of the clavicle. The fractures were classified according to Robinson as 16 type B1 and ten type B2. Read More

Echocardiography 2018 08 10;35(8):1233-1236. Epub 2018 Jun 10.

Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

The most commonly reported collateral systems in the setting of superior vena cava obstruction are azygos venous system, vertebral venous system, external and internal thoracic venous system based on McLntire and Sykes classification. A 49-year-old female with renal disease complained dyspnea on exertion. Transesophageal echocardiography showed significant mitral annular calcification, large multi-lobulated mass at posterior aspect of RA, and complete obstruction of superior vena cava by thrombus formation. Read More

Isr Med Assoc J 2018 Jan;20(1):53-57

Department of Internal Medicine B, Kaplan Medical Center, Rehovot, affiliated with Hebrew University-Hadassah Medical School, Jerusalem, Israel.

Background: Upper extremity deep vein thrombosis (UEDVT) is defined as thrombosis of the deep venous system (subclavian, axillary, brachial, ulnar, and radial veins), which drains the upper extremities. It can be caused by thoracic outlet anatomic obstruction, such as Paget-Schroetter syndrome, (primary) or by central intravenous catheters (secondary). UEDVT may be asymptomatic or present with acute severe pain and arm swelling. Read More

Medicine (Baltimore) 2018 Apr;97(15):e0327

Department of Emergency Medicine, Kaohsiung Medical University Hospital.

Rationale: Paget-Schroetter syndrome (PSS) is an uncommon condition that refers to primary (spontaneous) thrombosis of the deep veins that drain the upper extremities because of anatomical anomalies or repetitive strenuous arm activity. Bilateral spontaneous upper extremity deep-vein thrombosis (UEDVT) is an extremely rare phenomenon in adults, which may be misdiagnosed by physicians in acute settings.

Patient Concerns: A 40-year-old man presented to our emergency department because of progressive left upper arm swelling for 1 day. Read More

J Vasc Access 2018 May 27;19(3):297-302. Epub 2018 Mar 27.

3 Department of Surgery, Institute of Oncology, Istanbul University, Istanbul, Turkey.

Aim: To examine whether the real-time ultrasound-guided venipuncture for implantable venous port placement is safer than the traditional venipuncture.

Methods: The study analyzed the results of 2153 venous ports placed consecutively from January 2009 to January 2016. A total of 922 patients in group 1 and 1231 patients in group 2 were admitted with venous port placed using the traditional landmark subclavian approach and real-time ultrasound-guided axillary approach, respectively. Read More

Radiol Case Rep 2018 Feb 31;13(1):28-31. Epub 2017 Oct 31.

Department of Radiology, Eastern Virginia Medical School, PO Box 1980, Norfolk, VA 23501.

Paget-Schroetter syndrome, also known as effort thrombosis, is a relatively rare disease process characterized by primary thrombosis to the subclavian and axillary veins. It usually presents in younger individuals, commonly affecting the dominant side upper extremity, and the diagnosis relies on a combination of imaging, laboratory tests, and clinical presentation. Upper extremity deep vein thrombosis can also lead to pulmonary emboli, as in this case of a 20-year-old female discovered to have right sided Paget-Schroetter syndrome. Read More

Medicine (Baltimore) 2018 Mar;97(11):e9944

Department of Vascular Surgery and Endovascular Therapy.

Rationale: Thoracic outlet syndrome (TOS) is a rare cause of upper extremity deep vein thrombosis (UEDVT). The treatment usually involves catheter directed thrombolysis followed by systemic anticoagulation. Surgical decompression is frequently recommended after anticoagulation for definitive therapy. Read More

J Pediatr Surg 2018 May 7;53(5):1052-1055. Epub 2018 Feb 7.

Division of Pediatric Surgery, University of Texas Southwestern/Children's Health, Dallas, TX, United States. Electronic address:

Purpose: The purpose of this study was to investigate whether anticoagulation (AC) results in thrombus resolution and increased line longevity in children with intestinal failure (IF) and catheter-associated central venous thrombosis (CVT).

Methods: A retrospective, single institution review was performed of children with IF who were dependent on parenteral nutrition with known CVT between 2006 and 2017. Frequency of catheter-related complications including infection, occlusion, and breakage were compared 18months prior to and after starting AC. Read More

J Med Case Rep 2018 Feb 20;12(1):42. Epub 2018 Feb 20.

Clinic of Vascular Surgery, University Clinical Center of Kosovo, 10000, Pristina, Kosovo.

Background: The aim of the study was to analyze characteristics of patients with bilateral internal jugular vein thrombosis in our department during a 1-year period. Internal jugular vein thrombosis refers to an intraluminal thrombus occurring anywhere from the intracranial internal jugular vein to the junction of the internal jugular vein and the subclavian vein, which form the brachiocephalic vein. It can occur spontaneously or as a complication of head and neck infections, surgery, central venous lines, local malignancy, polycytemia, hyperhomocysteinemia, neck massage, or intravenous drug abuse. Read More

Ann R Coll Surg Engl 2018 Feb;100(2):83-91

Cardiff and Vale University Health Board , UK.

Introduction Paget-Schroetter syndrome is a rare effort thrombosis of the axillary-subclavian vein, mainly occurring in young male patients. Current management involves immediate catheter directed thrombolysis, followed by surgical decompression of the subclavian vein. This has been invariably performed using a transaxillary or supraclavicular approach. Read More

JAAPA 2018 Feb;31(2):1-4

At the time this article was written, Paige E. Carpenetti was a student in the PA program at Marietta (Ohio) College. She now practices family medicine in China Grove, N.C. John M. Grosel is an associate professor in the Marietta College PA program and a radiologist at Riverside Radiology and Interventional Associates, Inc., in Columbus, Ohio. The authors have disclosed no potential conflicts of interest, financial or otherwise.

Thoracic outlet syndrome can present with a wide variety of upper extremity neurovascular symptoms. Timely clinical recognition is essential for prompt treatment and maximal recovery. This article describes a case of thoracic outlet syndrome in a volleyball player with an underlying hypercoagulable state who presented with a subclavian vein thrombosis. Read More

Eur J Pediatr 2018 Mar 10;177(3):451-459. Epub 2018 Jan 10.

Pediatric Intensive Care Unit, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France.

Placement of a central venous catheter (CVC) in the brachiocephalic vein (BCV) via the ultrasound (US)-guided supraclavicular approach was recently described in children. We aimed to determine the CVC maintenance-related complications at this site compared to the others (i.e. Read More

Vascular 2018 Aug 4;26(4):410-417. Epub 2018 Jan 4.

1 Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houstan, TX, USA.

Objectives Thoracic outlet syndrome, a condition commonly reported in adults, occurs infrequently in the pediatric population. The objective of this study was to assess the outcome of surgical interventions of thoracic outlet syndrome in pediatric patients. Methods Clinical records of all pediatric patients with thoracic outlet syndrome who underwent operative repair from 2002 to 2015 in a tertiary pediatric hospital were reviewed. Read More

Anesth Essays Res 2017 Oct-Dec;11(4):1088-1090

Department of Anaesthesiology, Aga Khan University Hospital, Karachi, Pakistan.

A young male underwent decompressive craniotomy for an intracerebral bleed. A right-sided subclavian central venous catheter was placed in the operating room after induction of anesthesia. Postoperatively, he was shifted to Intensive Care Unit (ICU) for mechanical ventilation due to low Glasgow coma scale. Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2017 Dec;20(12):1393-1398

Department of Gastrointestinal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China.

Objective: To describe and analyze the complications of subcutaneous venous access port for patients with gastrointestinal malignancy.

Methods: Data of 1 912 patients with gastrointestinal malignancy who accepted chemotherapy in our department via subcutaneous venous access ports, including 127 cases in upper arm, 865 cases in subclavicular vein and 920 cases in internal jugular vein, from June 2007 to April 2016 were analyzed retrospectively. Associated complications and risk factors were emphatically investigated. Read More

Angiol Sosud Khir 2017;23(4):69-74

Ryazan State Medical University named after Academician I.P. Pavlov, Ryazan, Russia.

The problem of venous thromboembolic complications (VTECs) in patients with cardiovascular implantable electronic devices (CIEDs) is extremely important today because of an annually increasing number of surgical interventions for life-threatening arrhythmias and chronic heart failure. There are hitherto no clearly defined reliable risk factors for VTECs due to heterogeneity of the available literature data. Some sources point to elevated thrombus formation in patients with a large number of electrodes, in repeat operative interventions, in the presence of a temporary pacemaker, in implantation on the left side, silicon cover of an electrode, others refute these facts. Read More

Perfusion 2018 07 11;33(5):404-406. Epub 2017 Dec 11.

1 Division of Interventional Cardiology, Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan.

The use of central venous port access is increasing due to the requirements of multimodal intravenous therapy. However, catheter malposition in smaller veins can lead to vein thrombosis, phlebitis and pain. Herein, we report our experience with the use of percutaneous interventions to correct migrated port catheter malposition. Read More

J Vasc Surg 2018 03 16;67(3):860-867. Epub 2017 Nov 16.

Department of Surgery, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Korea.

Objective: The objective of this study was to conduct a prospective clinical trial evaluating the technical feasibility and short-term clinical outcome of the blind pushing technique for placement of pretrimmed peripherally inserted central catheters (PICCs) through brachial vein access.

Methods: Patients requiring PICC placement at any of the three participating institutions were prospectively enrolled between January and December 2016. The review boards of all participating institutions approved this study, and informed consent was obtained from all patients. Read More

Case Rep Hematol 2017 25;2017:7290945. Epub 2017 Sep 25.

Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

Deep vein thrombosis (DVT) is a rare disease in patients with hemophilia A. We report a case of 22-year-old male with severe hemophilia A who presented to the emergency room with 5-day history of right arm pain that was attributed initially to bleeding event. In the absence of external signs of bleeding or hematoma and normal hemoglobin level, we suspected an underlying DVT. Read More

J Vasc Surg Venous Lymphat Disord 2018 01 9;6(1):75-82. Epub 2017 Nov 9.

Department of Vascular Surgery, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. Electronic address:

Objective: Young, active persons may suffer lifelong consequences of subclavian vein thrombosis, but the best treatment options remain unclear. On introduction of more active pharmacomechanical thrombus removal and thoracoscopic rib resection in our institution, we planned a diagnostic and treatment protocol and aimed to analyze the early, midterm, and intermediate-term results.

Methods: The study included 72 patients who were diagnosed with an upper limb deep venous thrombosis and underwent phlebography between 2006 and 2013. Read More

Eur J Vasc Endovasc Surg 2018 02 26;55(2):292. Epub 2017 Oct 26.

Department of Vascular Surgery, Hospital Nacional de Clínicas, Córdoba, Argentina; Sanatorio Allende, Córdoba, Argentina.

Mil Med 2017 05;182(5):e1826-e1829

Medical Clinic, Marine Corps Air Station Miramar, 2496 Bauer Road, San Diego, CA 92145.

Background: Effort thrombosis, or Paget-Schroetter Syndrome, is an activity-induced upper extremity deep vein thrombosis affecting the axillary and/or subclavian vein. It is a rare disorder affecting 2 per 100,000 person years and mainly occurring in young, active individuals after repetitive upper extremity exertion. Effective diagnosis and management of this disorder has been difficult to study given the syndrome's rarity. Read More

Ann Vasc Surg 2018 Feb 22;47:253-259. Epub 2017 Sep 22.

Department of Vascular and Thoracic Surgery, University Hospital, Angers, France.

Background: Pectoralis minor compression syndrome (PMCS) is a compression of the neurovascular structures in the subpectoral tunnel and remains underestimated in the management of patients with thoracic outlet syndrome (TOS). Its underdiagnosis may be responsible for incomplete or failed treatment. The aim of the study was to evaluate the frequency of PMCS in our experience. Read More

Ann Vasc Surg 2018 Feb 8;47:69-77. Epub 2017 Sep 8.

Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Background: The objective was to evaluate the safety and feasibility of temporary superior vena cava (SVC) filter combined with balloon dilatation and catheter-directed thrombolysis for the treatment of catheter-related thrombosis (CRT) caused by implanted ports.

Methods: Between February 2014 and October 2016, 13 patients with implanted port-related CRT in internal jugular vein, brachiocephalic vein, and/or subclavian vein were treated by temporary SVC filter, balloon dilatation, and catheter-directed thrombolysis. Clinical data were retrospectively analyzed with respect to clinical characteristics, SVC filter placement and retrieval, balloon dilatation, and catheter-directed thrombolysis. Read More

Intern Med 2017 Oct 6;56(19):2595-2601. Epub 2017 Sep 6.

Division of Cardiology, Toho University Ohashi Medical Center, Japan.

A 29-year-old woman who worked as a KAATSU (a type of body exercise that involves blood flow restriction) instructor visited our emergency room with a chief complaint of swelling and left upper limb pain. Chest computed tomography (CT) showed non-uniform contrast images corresponding to the site from the left axillary vein to the left subclavian vein; vascular ultrasonography of the upper limb revealed a thrombotic obstruction at the same site, leading to a diagnosis of Paget-Schroetter syndrome (PSS). We herein report our experience with a case of PSS derived from thoracic outlet syndrome (TOS), in a patient who was a KAATSU instructor. Read More

AJR Am J Roentgenol 2017 Nov 31;209(5):1150-1157. Epub 2017 Aug 31.

1 Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, 1500 E Medical Center Dr, Ann Arbor, MI 48109.

Objective: The objective of our study was to describe an association between the radiographic appearance of distressed intravascular implants and venous stenosis or occlusion and to determine the success of reparative endovascular procedures.

Materials And Methods: Seventy-eight patients with distressed stents or inferior vena cava (IVC) filters characterized by pursing (short-axis contracture), straightening, longitudinal contraction (long-axis contracture), or fracture were identified from retrospective review of a venous registry for the period from February 2004 to October 2016. Patients originally presented with superior vena cava (SVC) syndrome (n = 25), arm swelling (n = 16), iliocaval thrombosis (n = 21), and lower extremity deep venous thrombosis (n = 16), and stents were initially placed in 65 and filters in 13. Read More