Thrombolysis and balloon venoplasty for subclavian vein thrombosis

Venous thrombosis due to thoracic outlet syndrome (VTOS) is often managed initially with thrombolysis since this provides some immediate relief of symptoms plus removing the thrombus allows for a more localized decompressive operation and decreases the risk of a pulmonary embolus. Thrombolysis can be achieved with either catheter directed infusion of a thrombolytic drug or by pharmacomechanical thrombolysis which uses mechanical devices to augment the thrombolytic effect and to help remove thrombus. Technical success rates are very high with only rare complications reported. Advances in pharmacomechanical technique have decreased both procedure times and use of thrombolytic drug.