Inazawa K, Simanuki T, Minowa T, Iijima Y, Orita H, Washio M
Second Department of Surgery, Yamagata University School of Medicine, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Aug;41(8):1410-4.
We report a effective management of the Paget-Schroetter syndrome. A 23-year-old man was seen with a complaint of arm swelling and venous engorgement of the left arm. A first-rib resection was performed through a infraclavicular approach with removal of compressive elements including scalenus anterior and subclavius muscles. He became asymptomatic. But 2 months later, recurrent symptoms developed and venograms demonstrated the presence of restenosis of the subclavian vein with extensive collaterals. To relieve symptoms a percutaneous transluminal angioplasty (PTA) and a insertion and placement of the Gianturco's expandable metallic stents was carried out for the remaining stenosis of the subclavicular vein and a residual compression. Venograms, 7 months after operation, showed widely the patent subclavian vein. Trans-infraclavicular approach allowed exposure of the stenotic or obstructed segments of the subclavian vein. The PTA and stenting, especially after removal of compressive elements or during chronic phase, was a very useful and effective procedure for the treatment of the Paget-Schroetter syndrome.
我们报告了佩吉特-施罗特综合征的有效治疗方法。一名23岁男性因左臂肿胀和静脉充血前来就诊。通过锁骨下途径进行了第一肋切除术，切除了包括前斜角肌和锁骨下肌在内的压迫性组织。他症状消失。但2个月后，症状复发，静脉造影显示锁骨下静脉再狭窄并伴有广泛侧支循环。为缓解症状，对锁骨下静脉残余狭窄和残余压迫进行了经皮腔内血管成形术（PTA）以及置入和放置了吉安图尔科可扩张金属支架。术后7个月的静脉造影显示锁骨下静脉广泛通畅。经锁骨下途径可暴露锁骨下静脉的狭窄或阻塞段。PTA和支架置入术，尤其是在去除压迫性组织后或慢性期，是治疗佩吉特-施罗特综合征非常有用且有效的方法。
