Long-Term Results of Local Thrombolysis Followed by First Rib Resection: An Encouraging Clinical Experience in Treatment of Subclavian Vein Thrombosis

24 patients with effort thrombosis of the subclavian vein, mean age 30.5 years, 21 men and 3 women, admitted to Academic Hospital Vrije Universiteit, Amsterdam, the Netherlands.

Local thrombolysis (streptokinase 10,000 units loading dose followed by 10,000 units per hour infusion for 2 to 8 days), followed by anticoagulation (heparin and coumarin derivatives for 3 months), and surgical decompression (transaxillary first rib resection, partial scalenotomy, and transection of the tendon of subclavian muscle) 6 to 12 weeks after thrombolysis.

Successful thrombolysis and long-term symptom relief