Right Upper Extremity DVT

Physician

Noah J. Jones, MD, MPH, FSCAI
David B. Jessup, MD, FACC, FSCAI
Interventional Cardiology
Vascular Medicine and Endovascular Interventions
North Cascade Cardiology
Bellingham, Washington

Background

A 16 year old female presented with significant swelling of the right upper extremity. The patient was on oral contraception for menorrhagia. The patient had swelling in her right upper extremity for 4 days prior to presentation. Duplex ultrasound demonstrated extensive right upper extremity deep vein thrombosis (DVT) with occlusive thrombus of the right subclavian vein and partial occlusion of the brachial vein. She was placed on catheter-directed thrombolytic infusion prior to this procedure without clinical success.

Procedure

The patient was treated with an 80cm x 15cm Trellis®-8 Peripheral Infusion System. A lytic dose of 4mg of t-PA was infused into the isolated treatment area and dispersed over a 20-minute run time. A stenotic lesion was subsequently identified post-isolated pharmacomechanical thrombolysis and treated with balloon angioplasty.

Conclusion

The result was complete thrombolysis and resolution of symptoms. The vein is 100% patent distal to the lesion.