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May 1988

Thrombolytic Therapy of Axillary-Subclavian Venous Thrombosis-Reply

Author Affiliations

La Crosse, Wis

Arch Surg. 1988;123(5):662-663. doi:10.1001/archsurg.1988.01400290148029

In Reply.—We appreciate the interest and expertise of Dr Molina concerning the treatment of axillary-subclavian vein thrombi. We agree that a combination of anticoagulation and surgery may improve the long-term outcome of patients with axillary-subclavian vein thrombosis. We disagree that there is "a definite consensus that all of these patients must be treated with surgery," and we disagree over which surgical procedures may be required. Dr Molina believes a consensus exists that there is "an intimal tear and extrinsic compression of the vein that must be released by patch angioplasty of the vein itself to preserve the patency of the vein." If a definite consensus does exist concerning patch angioplasty, then why do major textbooks of vascular surgery not advocate it for all patients?1-5 Patch angioplasty is also not recommended by the institution reporting the largest series, to our knowledge, in treating axillary thrombosis.6

Patch angioplasty of

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