Primary Subclavian Venous Thrombosis: Report of Three Cases and Review of the Japanese Literatures

Abstract

原発性鎖骨下静脈血栓症(Paget-Schroetter症候群)は静脈性胸郭出口症候群および特発性鎖骨下静脈血栓からなり，アルゴリズムに従った治療法が普及しつつある．3例の原発性鎖骨下静脈血栓症を保存的(血栓溶解療法，抗凝固療法)に治療し，1例は良好な鎖骨下静脈の開存を得ることができ，1例は狭窄を残したものの再開通を得ることができた．1例は鎖骨下静脈に閉塞を認めたが，豊富な側副血行路の発達を認めた．3例とも症状は完全に消失し社会復帰を果たした．本邦論文報告86例の中で，治療後の開存性の記載のある42例に関し検討し，本邦の治療の現状を概観するとともに，当院の治療方針を構築したので報告する． 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.