Thoracic Outlet Syndrome

Study data from Johns Hopkins University, Medical Department update understanding of thrombosis

"The average age was 31 years (range, 16-54); the 3 7 males and 30 females presented on average 9.2 months (range, 1 month-6 years) after acute thrombosis. Four treatment algorithms were utilized. In. group 1, 3 patients presented with acute occlusion and received tissue plasminogen activator (tPA) and immediate first rib resection with scalenectomy (FRRS). One vein rethrombosed and was treated by intravenous IPA postoperatively. In group 2, 39 patients presented with stenotic subclavian veins an average of 22 weeks after their initial thrombosis, all of whom underwent FRRS followed by a venogram 2 Weeks, postoperatively: 25 had a tight stenosis and underwent venoplasty with anticoagulation; 13 had patent, nonstenotic subclavian veins, and I patient required tPA and venoplasty owing to rethrombosis. Two patients had their subclavian vein thrombose after venoplasty and were treated with anticoagulation, IPA, and venoplasty. In group 3, 11 patients presented with intermittent venous obstruction without thrombosis and underwent FRRS; 3 underwent venograms because of concerns of residual stenosis, 2 of whom required venoplasty postoperatively. Finally, in group 4, 14 patients presented with occluded subclavian veins and underwent FRRS with long-term anticoagulation. Eleven have recanalized at an average of 6 months (range, 2-12). Overall, 64 of 6 7 patients have patent subclavian veins after a median follow-up of 10 months, and all patients are asymptomatic for a success rate of 96%," wrote R.A. Deleon and colleagues, Johns Hopkins University, Medical Department.

The researchers concluded: "Tailored treatment algorithms including FRRS, postoperative venograms with or without intervention, and the use of long-term anticoagulation seems to be required in this complicated g-roup of young patients to achieve optimal results. (Surgery 2009; 145:500-7.)'."

Deleon and colleagues published their study in Surgery (Multiple treatment algorithms for successful outcomes in venous thoracic outlet syndrome. Surgery, 2009;145(5):500-507).

For more information, contact J.A. Freischlag, Johns Hopkins University, Institute Medical, Dept. of Surgery, Richard Starr Ross Research Bldg, 720 Rutland Avenue Ross, Baltimore, MD 21205, USA.

Publisher contact information for the journal Surgery is: Mosby-Elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA.

Keywords: United States, Baltimore, Acute Thrombosis, Angiology, Business, Enzyme Research, Hematology, Patent Actions, Patents, Plasminogen, Rheumatology, Scalenectomy, Stenosis, Subclavian Vein, Surgery, Therapy, Thoracic Outlet Syndrome, Treatment, Johns Hopkins University, Medical Department.

This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2009, Biotech Business Week via NewsRx.com.