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V.-subclavia-Thrombose bei Thoracic-inlet-Syndrom

Thrombosis of the subclavian vein in thoracic inlet syndrome

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Zusammenfassung

Hintergrund

Das Thoracic-inlet-Syndrom (Synonym: Paget-von-Schroetter-Syndrom) bei einer V.-sublavia-Thrombose ist eine seltene Form des Thoracic-outlet-Syndroms. Es betrifft typischerweise junge, aktive, ansonsten gesunde Patienten. Der venöse Verschluss ist Folge einer wiederholten Kompression im Bereich der oberen Schulterapertur zwischen erster Rippe, Clavicula, Mm. scaleni et subclavius und Lig. costoclaviculare.

Fragestellung

Wie sind die Behandlungsabläufe?

Ergebnisse

Allgemeiner Konsens ist, dass die Kombinationstherapie aus kathetergestützter Thrombolyse, Antikoagulation, Dekompressionsoperation und Rehabilitation erfolgreich ist. Für dieses Krankheitsbild wird in 90–100 % ein völlig symptomfreies Langzeitergebnis erzielt.

Schlussfolgerungen

Obwohl keine prospektive randomisierte Studienlage zur Behandlung des Krankheitsbildes vorliegt, sind die Behandlungsempfehlungen allgemein konsentiert.

Abstract

Background

Thoracic inlet syndrome, also known as the Paget-Schroetter syndrome, occurs due to thrombosis of the subclavian vein and is a rare form of thoracic outlet syndrome. It typically presents in young, active and otherwise healthy adults. It is considered to be a consequence of compression and repetitive injury of the subclavian vein between the first ribs and the overlying clavicle, the scalenus anterior muscle, subclavius muscle and costoclavicular ligament.

Objective

What are the treatment options and procedures?

Results

The general consensus is that combined treatment involving catheter-assisted thrombolysis, anticoagulation therapy, operative decompression and rehabilitation is the most successful approach. Completely symptom-free long-term success rates of 90–100 % can be achieved.

Conclusion

Although prospective randomized trials addressing treatment of this entity are lacking, there is general consensus on the treatment recommendations.

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Authors and Affiliations

  1. Klinik für Gefäßchirurgie, Agaplesion Diakonie-Klinik Kassel, Herkulesstraße 34, 34119, Kassel, Deutschland

    T. Bürger, H. Baumbach & N. Weiske

  2. Klinik für Angiologie und Allgemeine Innere Medizin, Agaplesion Diakonie-Klinik Kassel, Kassel, Deutschland

    E. Stegemann

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  1. T. Bürger
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  2. E. Stegemann
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  3. H. Baumbach
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  4. N. Weiske
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Correspondence to T. Bürger.

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Interessenkonflikt

T. Bürger, E. Stegemann, H. Baumbach und N. Weiske geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Bürger, T., Stegemann, E., Baumbach, H. et al. V.-subclavia-Thrombose bei Thoracic-inlet-Syndrom. Gefässchirurgie 21, 558–566 (2016). https://doi.org/10.1007/s00772-016-0210-2

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