In Reply to: Case 0298_10 --Mechanical thrombolysis for effort vein thrombosis posted by Editor on February 03, 1998 at 11:52:28:
This is a tough problem that we cannot fix comoletely ourselves (as much as we want to). The costo-clavicular junction is stent-unfriendly even in patients without thoracic outlet problems. So resection of rib is a good option. We had a similar case where we used UK to declot and then stented the area. In spite of coumadin it did not stay open for more than a few weeks. The surgeons are not too enthusiastic to perform this fairly complex surgery for what is essentially a benign problem. Even without intervention it does get better when collaterals form.