[Urokinase recanalization of extensive thrombosis of the superior vena cava secondary to an implantable perfusion device].

A superior vena cava syndrome developed suddenly in a 36 year old man who had been undergoing chemotherapy via an implanted venous access catheter for 18 months. Venography showed superior vena cava thrombosis extending bilaterally to the subclavian veins. Direct local thrombolysis with low-dose Urokinase resulted in partial recanalisation with an excellent clinical result despite the persistence of an endovenous sequestrum situated at the catheter tip, a sequela of previous thrombosis. This case underlines the importance of direct local thrombolysis in patients with a Port-a-Cath system complicated by a thrombosis.