静 脈 学 Table 1 Patient characteristics Symptom Case Age Sex Site PE Cause Treatment 1 44 M RSCV swelling (+) unknown UK, anticoaglant patent Result 2 5
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1 Paget-Schroetter 3 Paget-Schroetter Paget-Schroetter Paget-Schroetter 3 Table CT CT CT Fig CT Fig. 2 71
2 静 脈 学 Table 1 Patient characteristics Symptom Case Age Sex Site PE Cause Treatment 1 44 M RSCV swelling (+) unknown UK, anticoaglant patent Result 2 54 M LSCV swelling, numbness ( ) labor UK, anticoaglant stenosis 3 49 M LSCV swelling ( ) labor UK, anticoaglant occlusion A Fig. 1 B Case 1; Delayed phase CT. A: pre-treatment, B: post-treatment A B Fig. 2 Case 2; Venography. A: pre-treatment, B: post-treatment 72
3 Fig. 3 Case 3; Venography (past-treatment) CT Fig Paget-Schroetter PSS TOS TOS PSS TOS costclavicular space TOS PSS PSS TOS TOS TOS CDT Hurlbert Rutherford 1 CDT 1 73
4 Table 2 Cases of surgical treatement collected from Japanese literature No Report year Auther Age Sex Day Operative procedure Outcome Murakami 20 M 0 Thrombectomy, Patch plasty Patent Ishii 40 M 1M Bypass Occlusion Okamoto 19 M 7 Rib resection, Thrombectomy Stenosis 4 19 Takahashi 25 M 13 Thrombectomy, Patch plasty Patent 5 19 Takahashi 26 M 0 Thrombectomy, Patch plasty Stenosis Sueda 46 M 10 Thrombectomy Patent Akao 38 M 1 Thrombectomy, Patch plasty Stenosis Ando 36 M 0 Thrombectomy Occlusion Matsuo 22 M 5 Thrombectomy Occlusion Matsuo 28 M 1 Thrombectomy, Patch plasty Occlusion Inasawa 23 M 2M Rib resection, Stent Patent Hanafusa 19 M 20 Rib resection, Bypass Occlusion Kawai 24 F 1M Rib resection Occlusion Aoyama 28 M 3M Ligation Occlusion Ejiri 16 M 3M Rib resection Stenosis Endo 17 M 1 Rib resection Patent Naito 22 M 1Y Rib resection Patent Yamakawa 37 M Rib resection, Patch plasty Stenosis PSS 2 TOS 3 TOS 4 PTA stent 5 6 Molina Emergency protocol 1 PSS CDT cm PTA cm Molina PSS ~
5 Table 3 Cases of conservative treatment collected from Japanese literature No Report year Auther Age Sex Day Treatment Outcome 1 19 Takahashi 17 M 3 Thrombolysis Occlusion 2 19 Takahashi 71 M 4 Thrombolysis Patent Kamaya 47 M 12 Thromboyisis, Anticoagulation Occlusion Masuoka 36 M 6 Thrombolysis, Anticoagulation Patent Ri 19 M 20 Thrombolysis, Antiplateret Occlusion Imamura 17 M 3M Patent Kimura 34 F 6M Thrombolysis, Antiplateret Occlusion Nishiyama 19 F 0 Thrombolysis, Anticoagulation Occlusion Matsuo 67 M 12 Thrombolysis, Anticoagulation Occlusion Mukai 15 M 8 Thrombolysis Patent Futamura 21 M 7 Thrombolysis, Anticoagulation, Antiplateret Occlusion Oota 36 F 1M CDT, PTA, Filter Patent Odashiro 33 M 1 Thronbolysis, Anticoagulation Occlusion Odashiro 24 M 2 Thrombolysis, Anticoagulation Occlusion Shimizu 22 F 1 Thrombolysis, Anticoagulation Stenosis Taira 55 M 10 Thrombolysis, Anticoagulation Stenosis Kobayashi 39 M 1 Thrombolysis, Anticoagulation Occlusion Shimizu 60 M 14 CDT, PTA Patent Uchida 43 F 3 CDT, Anticoagulation Stenosis Uchida 16 M 1 CDT, Anticoagulation Stenosis Ichinose 64 M Thrombolysis, Filter Stenosis Mituha 30 M 2 Anticoagulation Occlusion Funatsu 50 M 7 CDT, PTA, Anticoagulation Patent Chiba 20 M 3 CDT, PTA, Anticoagulation Patent Table ~ CDT 6 CDT CDT Table TOS 1999 CDT TOS CDT Hurlbert Rutherford 1 CDT
6 TOS Molina 4 CDT TOS 2 PSS 3 PSS 1 Hurlbert SN, Rutherford RB: Subclavian-axillary vein thrombosis. Vascular Surgery. 5th Ed. Rutherford RB ed. Philadelphia, WB Saunders, 2000, pp Molina JE, Hunter DW, Dietz CA: Protocols for Paget- Schroetter syndrome and late treatment of chronic subclavian vein obstruction. Ann Thorac Surg 2009; 87: ; 25: ; XXX: ; 18: ; 17: Thrombectomy ; 35: ; 3: Paget-Schroetter ; 48: ; 1: Paget- Schroetter syndrome PTA ; 41: Paget-Schroetter ; 7: Paget-Schroetter ; 18: Aoyama T, Suehiro S, Shibata T, et al: Paradoxical cerebral embolism in patient with Paget-Schroetter syndrome. Ann Thorac Cardiovasc Surg 2005; 11: Paget-Schroetter ; 41: ; 18: Paget-Schroetter ; 28: Paget-Schroetter ; 19: Med Postgrad 1979; 17: Med Postgrad 1980; 18: ; ; 2: Paget-Schroetter syndrome 1 76
7 ; 47: ; 41: ; 54: ; 55: Ther Res 1999; 20: Paget-Schroetter ; 52: ; 48: ; 17: Paget-Schroetter ; 40: Paget-Schroetter 1 Ther Res 2008; 28: Paget-Schroetter Catheterdirected Thrombolysis CDT ; 24; Paget-Schroetter ; 43: Abstract Primary Subclavian Venous Thrombosis: Report of Three Cases and Review of the Japanese Literatures Shigeki Hirooka, Yoko Sotoda, Yuriko Kobayashi, and Hiroyuki Orita Department of Cardiovascular Surgery, Saiseikai Yamagata Saisei Hospital Key words: primary subclavian venous thrombosis, Paget-Schroetter syndrome, venous thoracic outlet syndrome Significant improvements were made in management of primary subclavian venous thrombosis due to venous thoracic outlet syndrome and unknown cause. The management according to the algorithm has become popular. We reviewed 86 cases from Japanese literatures and noticed that the aim of the management is recovery from symptoms in Japan although various treatments have been performed for patients. We treated three patients of primary subclavian venous thrombosis (Paget-Schroetter syndrome) with combined conservative therapy (thrombolysis and anticoagulant). All patients were relieved from symptoms and returned to social life without any complications. We constructed our protocol to treat Paget-Schroetter syndrome. Jpn J Phlebol 2013; 24 (1): 71-
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