Abstract
-Primary axillary-subclavian vein thrombosis with associated symptoms of painful swelling and cyanosis of the upper extremity is best treated with catheter-directed thrombolysis. Following lysis the subclavian vein is evaluated for extrinsic compression, which is frequently observed as the vein crosses the first rib. First rib resection followed by balloon dilation of the stricture and stenting if necessary has proven to be a successful and durable approach. Catheter-directed thrombolysis is also the most effective technique to treat secondary axillary-subclavian venous thrombosis, although in some patients removal of the indwelling catheter and anticoagulation is also a satisfactory therapy.
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