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Long-Term Sequelae of Spontaneous Axillary–Subclavian Venous Thrombosis

Emmanuel Héron, MD; Olivier Lozinguez, MD; Joseph Emmerich, MD, PhD; Claude Laurian, MD; and Jean-Noël Fiessinger, MD
[+] Article and Author Information

From Hôpital Broussais and Hôpital Saint-Joseph, Paris, France.


Acknowledgment: The authors thank Professor Gilles Chatellier (Service d'Informatique Médicale, Hôpital Broussais) for help with the statistical analyses.

Requests for Reprints: Jean-Noël Fiessinger, MD, Service de Médecine Vasculaire, Hôpital Broussais, 96 rue Didot, 75674 Paris Cedex 14, France.

Current Author Addresses: Drs. Héron, Lozinguez, Emmerich, and Fiessinger: Service de Médecine Vasculaire and Centre Claude Bernard de Recherche sur les Maladies Vasculaires Périphériques, Hôpital Broussais, 96 rue Didot, 75674 Paris Cedex 14, France.

Dr. Laurian: Service de Chirurgie Vasculaire, Hôpital Saint-Joseph, 185 rue Raymond Losserand, 75674 Paris Cedex 14, France.


Ann Intern Med. 1999;131(7):510-513. doi:10.7326/0003-4819-131-7-199910050-00006
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Background: The frequency and severity of post-thrombotic sequelae after spontaneous axillary–subclavian venous thrombosis remain poorly known.

Objective: To determine the late sequelae of conventionally treated spontaneous axillary–subclavian venous thrombosis.

Design: Cross-sectional study.

Setting: University department of vascular medicine.

Patients: 54 patients seen during an 18-year period (mean follow-up, 5 years).

Measurements: Scores for the severity of post-thrombotic symptoms were graded on a numerical rating scale ranging from 0 to 10 and on a 6-point verbal rating scale. Ultrasonographic sequelae were classified as grade 0, normal flow; grade 1, moderate obstruction; or grade 2, severe obstruction or occlusion.

Results: Verbal scores were “nil/negligible” in 47% of patients and “severe/intolerable” in 13%; numerical scores were 0 to 3 in 78% of patients and 7 to 10 in 9%. Grade 2 ultrasonographic sequelae were found in 22% of cases. No relation was seen between ultrasonographic sequelae and symptom severity scores.

Conclusion: The overall clinical outcome of spontaneous axillary–subclavian venous thrombosis is good, and there is no relation between the severity of late symptoms and ultrasonographic sequelae.

Figures

Grahic Jump Location
Figure.
Left. Patients' ratings of long-term symptom severity in 54 arms with spontaneous axillary–subclavian venous thrombosis.Right. Relation between clinical and ultrasonographic sequelae in 49 arms.

Scores from an 11-point numerical rating scale are plotted against ratings on a 6-point descriptive scale. Grade 0, normal flow; grade 1, moderate obstruction; grade 2, severe obstruction or occlusion of the axillary–subclavian vein.

Grahic Jump Location

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Summary for Patients

Long-Term Symptoms after Spontaneous Clots in Upper Arm Veins

The summary below is from the full report titled “Long-Term Sequelae of Spontaneous axillary–subclavian Venous Thrombosis.” It is in the 5 October 1999 issue of Annals of Internal Medicine (volume 131, pages 510-513). The authors are E. Héron, O. Lozinguez, J. Emmerich, C. Laurian, and J.-N. Fiessinger.

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