Successful Catheter-Directed Thrombolysis of Massive Bilateral Upper Extremity DVT Presenting as Superior Vena Cava Syndrome

Yashwant Agrawal; Jean-Yves R Nazroo; Nihar Jena; Vince Marceau; Dominika Zoltowska; Michele DeGregorio; Kirit Patel

doi:10.1016/j.jaccas.2019.11.008

Successful Catheter-Directed Thrombolysis of Massive Bilateral Upper Extremity DVT Presenting as Superior Vena Cava Syndrome

JACC Case Rep. 2019 Dec 18;1(5):803-806. doi: 10.1016/j.jaccas.2019.11.008.

Authors

Yashwant Agrawal¹, Jean-Yves R Nazroo¹, Nihar Jena¹, Vince Marceau¹, Dominika Zoltowska², Michele DeGregorio¹, Kirit Patel¹

Affiliations

¹ St. Joseph Mercy Oakland Hospital, Pontiac, Michigan.
² University of Florida College of Medicine, Cardiovascular Disease Fellowship, Jacksonville, Florida.

Abstract

Superior vena cava syndrome (SVCS) is traditionally associated with malignancy. However, approximately one-third of SVCS cases are due to intravascular devices and pacemakers. No specific guidelines exist for managing catheter-associated SVCS. We present catheter-associated SVCS resistant to anticoagulation, angioplasty, and thrombectomy but resolved with ultrasound-assisted catheter directed thrombolysis. (Level of Difficulty: Intermediate.).

Keywords: AV, axillary vein; BCV, brachiocephalic veins; CDT, catheter-directed thrombolysis; CTV, computed tomography with venogram; Doppler ultrasound; EKOS, EndoWave infusion catheter system; IJV, internal jugular vein; SCLV, subclavian veins; SVCS, superior vena cava syndrome; anticoagulation; computed tomography; imaging; intravascular ultrasound; shortness of breath; thrombosis; thrombus; vascular disease; x-ray fluoroscopy.

Publication types

Case Reports