Effort Thrombosis: Effective Treatment with Vascular Stent After Unrelieved Venous Stenosis Following a Surgical Release Procedure

Abstract

Acute symptomatic effort thrombosis in a 33-year-old male necessitated an aggressive approach consisting of thrombolysis, angioplasty, and surgical thoracic outlet release. The patient required postoperative placement of a Wallstent and was placed on anticoagulation. He has remained symptom free for the past 10 months, both clinically and sonographically.

Effort Thrombosis in the Elite Throwing Athlete

“…30,39 Urokinase is considered a safe and effective treatment. 1,2,12,28,34 Concurrent with the use of these thrombolytic agents, a variety of other treatments have also been recommended, including venous thrombectomy and anticoagulant therapy, 19 venous stent placement, 10,14 vein reconstruction, 6,25,26 low molecular weight heparin, 35 and surgical decompression of the thoracic outlet. 3,5,7,21,23,36 Over the past 10 to 15 years, there have been many published reports attempting to clarify which of these treatments is the most effective.…”

“…27,33 Venous thrombosis of the upper extremity has been termed "effort thrombosis" because of its common association with repetitive upper extremity activities. 2,5,10,13 Although uncommon in the elite throwing athlete, effort thrombosis has a characteristic clinical picture that requires timely diagnosis and treatment. Previously published individual case reports offer little guid-ance with respect to current diagnostic and therapeutic alternatives in this select patient population.…”