This study reports our experience with eight cases of subclavian vein thrombosis in patients with head and neck cancer. The extent of patients’ underlying disease, surgical procedures or radiotherapy performed, relationship to central venous catheters, nature of the thrombosis, incidence of emboli, and therapy instituted are examined. Analysis of these cases reveals that 43% (three patients) developed pulmonary emboli despite therapy. Stage IV disease was present in 86% (seven) of the patients in this review. Specific recommendations regarding early recognition, diagnosis, treatment, and possible implications for head and neck surgical procedures are made.
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References
1.
BorjaAR: Current Status of infraclavicular subclavian vein catheterization. Ann Thorac Surg1972; 13: 614–624.
2.
JamesPMMyersRT: Central venous pressure monitoring: Complications and a new technic. Am Surg1973; 39: 75–81.
NottageWM: Iatrogenic superior vena cava syndrome: A complication of internal jugular venous catheters (letter). Chest1976; 70: 566–567.
5.
BlackettRLBakranABradleyJA: A prospective study of subclavian vein catheters used exclusively for the purpose of intravenous feeding. Br J Surg1978; 65: 393–395.
6.
AhmedNPayneRF: Thrombosis after central venous cannulation. Med J Aust1976; 21: 217–220.
7.
HoshalVLAuseRGHoskinsPA: Fibrin sleeve formation in indwelling subclavian central venous catheters. Arch Surg1971; 102: 353–358.
8.
DyeLESegallPHRussellROJr: Deep venous thrombosis of the upper extremity associated with use of the Swan-Ganz catheter. Chest1978; 73: 673–675.
9.
StoneyWSAddlestoneRBAlfordWCJr: The incidence of venous thrombosis following long-term transvenous pacing. Ann Thorac Surg1976; 22: 166–170.
10.
WaltersMBStangerHARobinCE: Complications with percutaneous central venous catheters. JAMA1972; 220: 1445–1457.
11.
CampbellCBChandlerJGTegtmeyerCJ: Axillary, subclavian, and brachiocephalic vein obstruction. Surgery1977; 82: 816–826.
12.
McNeillR: Internal jugular vein thrombosis. Head Neck Surg1981; 3: 247–250.
13.
PollakWWalshJ: Subclavian-axillary venous thrombosis: Role of noninvasive diagnostic methods. South Med J1980; 73: 1503–1506.
14.
AdamsJTMcEvoyRKDeWeeseJA: Primary deep venous thrombosis of the upper extremity. Arch Surg1955; 91: 29–42.
15.
StephenMLoewenthalJWongJ: Complications of intravenous therapy. Med J Aust1976; 2: 557–559.
16.
LordJWStonePW: Pectoralis minor tenotomy and anterior scalenotomy with special reference to the hyperabduction syndrome and “effort thrombosis” of the subclavian vein. Circulation1956; 13: 537–542.
17.
LiebermanJSBorreroJUrdanetaE: Thrombophlebitis and cancer. JAMA1961; 177: 542–545.
18.
AmundsenMASpittellJAThompsonJHJr: Hypercoagulability associated with malignant disease and with the postoperative state: Evidence for elevated levels of antihemophilic globulin. Ann Intern Med1963; 58: 608–616.
19.
RubensteinMCregerWP: Successful streptokinase therapy for catheter-induced subclavian vein thrombosis. Arch Int Med1980; 140: 1370–1371.
20.
RoschJDotterCTSeamanAJ: Healing of deep venous thrombosis: Venographic findings in a randomized study comparing streptokinase and heparin. Am J Roentgenol1976; 127: 553–558.
