Theiss W, Wirtzfeld A
Dtsch Med Wochenschr. 1982 Jun 18;107(24):933-6. doi: 10.1055/s-2008-1070049.
19 patients were treated with streptokinase and (or) urokinase for primary thrombosis of the subclavian and (or) axillary vein (Paget-von-Schroetter-syndrome) of 2 to 28 days' duration. Phlebograms revealed significant improvement in 18 of the 19 patients (complete recanalization in 11, partial recanalization in 7). In those 17 patients whose symptoms had been present for up to 2 weeks the clinical outcome was entirely independent of the delay between the appearance of first symptoms and the start of fibrinolytic therapy, and even in the 2 patients wih an even longer delay complete recanalization was achieved in one (delay of 3 weeks) and partial recanalization in the other (delay of 4 weeks). However, since major clinical improvement occurs also spontaneously in most patients, a clear indication for fibrinolytic therapy exists only in particularly young patients and in those patients who depend on an absolutely perfect function of their upper extremities. In addition, the good results obtained with delayed fibrinolytic therapy justify extending this indication to those remaining patients in whom prior conservative management with elevation of the arm and anticoagulant therapy does not result in sufficient clinical improvement.
19例锁骨下静脉和（或）腋静脉原发性血栓形成（佩吉特 - 冯·施罗特综合征）患者，病程2至28天，接受了链激酶和（或）尿激酶治疗。静脉造影显示，19例患者中有18例有显著改善（11例完全再通，7例部分再通）。在症状出现长达2周的17例患者中，临床结果完全独立于首次症状出现与纤溶治疗开始之间的延迟时间，即使在延迟时间更长的2例患者中，1例实现了完全再通（延迟3周），另1例实现了部分再通（延迟4周）。然而，由于大多数患者也会自发出现显著临床改善，因此纤溶治疗的明确指征仅存在于特别年轻的患者以及那些依赖上肢绝对完美功能的患者中。此外，延迟纤溶治疗取得的良好结果证明，对于那些先前采用手臂抬高和抗凝治疗的保守治疗未取得足够临床改善的其余患者，也可将此指征扩展适用。
