What is the clinical evidence from this study?

Study design: Systematic Review. Population: Axillary and subclavian deep venous thrombosis (n=329). Intervention: Axillary and subclavian deep venous thrombosis. Primary outcome: Posttreatment symptoms, pulmonary embolism, and death.

What does this research mean for the field?

Axillary and subclavian deep venous thrombosis is associated with posttreatment symptoms in 34% of cases, pulmonary embolism in 9.4%, and death in 1.2% regardless of etiologic category. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

Clarify the prognosis of axillary and subclavian deep venous thrombosis and determine the clinical factors influencing long-term complications.

October 1, 1991Archives of Internal Medicine

Axillary and subclavian venous thrombosis. Prognosis and treatment

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Key result

Axillary and subclavian DVT linked to posttreatment symptoms in ~34% of cases and subsequent PE.

n=329

Why the study?

The prognosis of axillary and subclavian deep venous thrombosis and the clinical factors influencing its sequelae were unclear due to limited and low-quality data.

Comparison

Various treatments including anticoagulation, thrombolytic agents, and surgery

Design

Systematic review of English-language literature since 1950

Authors

DBD. M. Becker

Discussion

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Implication

Axillary-subclavian DVT carries notable morbidity risk; leaves open optimal therapy, warranting RCTs.

Key Points

Clarify the prognosis of axillary and subclavian deep venous thrombosis and determine the clinical factors influencing long-term complications.
Systematically reviewed English-language literature published between 1950 and 1991.
Identified and analyzed clinical data from 71 case reports and 17 case series comprising a total of 329 patients.
Posttreatment symptoms were documented in 34% of cases, pulmonary embolism occurred in 9.4% (half confirmed by lung scan or angiography), and overall mortality was 1.2% (three of four deaths resulted from pulmonary emboli).
Complication rates occurred irrespective of etiology, showing similar risks across spontaneous, catheter-related, and miscellaneous presentations.
Controlled trial evidence supporting thrombolysis or surgical intervention over standard anticoagulation was absent.

Study Design

Type

Systematic Review (n=329)

Structured PICO

Population

329 patients with axillary and subclavian deep venous thrombosis from 71 case reports and 17 case series published since 1950.

Exposure

Various treatments including anticoagulation, thrombolytic agents, and surgery

Outcome

Prognosis and sequelae including posttreatment symptoms, pulmonary embolism, and deathhard clinical

Axillary and subclavian deep venous thrombosis carries significant risks of posttreatment symptoms and pulmonary embolism, highlighting the need for controlled trials to guide therapy.

Limitations

Major deficiencies in the quality and quantity of available clinical data
Few patients enrolled at inception
Outcome assessments susceptible to bias and based on insensitive diagnostic tests
No controlled trials to support any one treatment approach
Outcome assessments susceptible to bias
Based on insensitive diagnostic tests
No controlled trials available

Cite This Study

D. M. Becker (1991) conducted a systematic review in Axillary and subclavian deep venous thrombosis (n=329). Axillary and subclavian deep venous thrombosis was evaluated on Posttreatment symptoms, pulmonary embolism, and death. Axillary and subclavian deep venous thrombosis was associated with posttreatment symptoms in 34% of cases, pulmonary embolism in 9.4%, and death in 1.2%.

synapsesocial.com/papers/6aaa5509f5e945fe6954c577 https://doi.org/10.1001/archinte.151.10.1934

Topics

Pulmonary embolism

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Axillary and subclavian venous thrombosis. Prognosis and treatment

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Topics

Axillary and subclavian venous thrombosis. Prognosis and treatment

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider