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Long-term sequellae of spontaneous axillo-subclavian venous thrombosis Volume 12, issue 7, Août - Septembre 2000

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  • Page(s) : 448-52
  • Published in: 2000

Spontaneous axillo-subclavian thrombosis is a pathology of young adults, mainly related to mechanical trauma. The possibility of a long-term invalidating post-phlebitis syndrome is the main risk. However, this risk is modest and does not appear to depend on "aggressive management" with thrombolysis followed by surgical section of the first rib and eventually venous angioplasty, compared with treatment by oral anticoagulants alone. The reference studies of these two therapeutic approaches report severe long-term sequellae in about 1 in 10 patients whereas 1 in 2 patients become totally asymptomatic with nothing but oral anticoagulation for three months. Anticoagulation alone remains the reference treatment of this type of venous thrombosis and thrombolysis should only be proposed in randomised clinical trials (which are still awaited), or special cases, after careful consideration of the benefit/risk ratio and informed patient consent.