Paget-Schroetter disease medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
- An effective treatment approach with lower rate of recurrent thrombus is a combination of Anti-coagulation, Thrombolytic agents and surgical decompression.
- Catheter-directed thrombolysis injection has proven to be effective as systemic thrombolytic agents without any worrisome systemic side effects.
Medical Therapy
- Considering more belligerent treatment method cite greater outcomes with lower rate of recurrent thrombus. Belligerent treatment method compromises of anticoagulation, thrombolytic agents, and surgical decompression of the thoracic outlet with repair of the affected venous system.[1]
- Systemic fibrinolysis:
- More efficient than anticoagulation therapy[2]
- Higher chance of developing worrisome complications like intracranial hemorrhage compared to anticoagulation therapy[3]
- Local catheter-directed thrombolysis:
- Recommended in all early presenting patients based on some studies[4], while others suggest this method for sever cases, large thrombus, low risk of bleeding, patients with good general health condition and life expectancy more than a year.[5]
- Studies have been demonstrated that there is an indirect relationship between efficacy of local thrombolytic therapy and duration between symptom onset to treatment. Therefore it is critical to diagnose and treat as soon as possible.[6] Some studies suggest to consider local catheter-directed thrombolysis within the first 14 days of symptoms onset with success rate of 84%[7]
- Same efficacy as systemic thrombolytic agents without any systemic side effects[8]
- Newer agents like Alteplase and Reteplase are safer compared to urokinase or streptokinase [9]
- The average duration of thrombolytic infusion via catheter is estimated between 24-48 hours[10]
References
- ↑ Ringhouse, Brendan; Jackson, Cody (2017). "Bringing to Light Symptoms and Treatments of Effort Thrombosis (Paget–Schroetter Syndrome) in the Military Population, a Case Study". Military Medicine. 182 (5): e1826–e1829. doi:10.7205/MILMED-D-16-00359. ISSN 0026-4075.
- ↑ Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK (2010). "Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis". West J Emerg Med. 11 (4): 358–62. PMC 2967689. PMID 21079709.
- ↑ Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK (2010). "Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis". West J Emerg Med. 11 (4): 358–62. PMC 2967689. PMID 21079709.
- ↑ Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK (2010). "Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis". West J Emerg Med. 11 (4): 358–62. PMC 2967689. PMID 21079709.
- ↑ Ringhouse, Brendan; Jackson, Cody (2017). "Bringing to Light Symptoms and Treatments of Effort Thrombosis (Paget–Schroetter Syndrome) in the Military Population, a Case Study". Military Medicine. 182 (5): e1826–e1829. doi:10.7205/MILMED-D-16-00359. ISSN 0026-4075.
- ↑ Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK (2010). "Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis". West J Emerg Med. 11 (4): 358–62. PMC 2967689. PMID 21079709.
- ↑ Ringhouse, Brendan; Jackson, Cody (2017). "Bringing to Light Symptoms and Treatments of Effort Thrombosis (Paget–Schroetter Syndrome) in the Military Population, a Case Study". Military Medicine. 182 (5): e1826–e1829. doi:10.7205/MILMED-D-16-00359. ISSN 0026-4075.
- ↑ Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK (2010). "Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis". West J Emerg Med. 11 (4): 358–62. PMC 2967689. PMID 21079709.
- ↑ Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK (2010). "Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis". West J Emerg Med. 11 (4): 358–62. PMC 2967689. PMID 21079709.
- ↑ Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK (2010). "Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis". West J Emerg Med. 11 (4): 358–62. PMC 2967689. PMID 21079709.