Abstract:Objective To evaluate the clinical value of interventional therapy for secondary axillary-subclavian venous thrombosis. Methods The clinical data of 32 patients with secondary axillary-subclavian venous thrombosis in acute stage (less than or equal to 14 days) from January 2011 to June 2016 were analyzed retrospectively. The anticoagulant therapy with subcutaneous injection of low molecular heparin was given in all patients. On the basis of anticoagulant therapy, 20 patients were treated with catheter-directed thrombolysis (CDT) therapy ［by transvenous catheterization, the head end of thrombolytic catheter was implanted into the thrombus segment and was retained, and then injection of low dose urokinase (25-75) ×10 000 IU/d was given via catheter for continuous thrombolytic therapy (6.3±3.3) d], and the remaining 12 patients were treated with anticoagulant therapy only. According to bleeding risk assessment HAS-BLED scoring, rivaroxaban or warfarin anticoagulant therapy was used at least three months after discharge. The curative effects of CDT combined with anticoagulant therapy and pure anticoagulant therapy were analyzed. Results There were no significant differences in the length of hospital stay [(11.9±5.3) d vs (9.8±3.8)d], the difference of circumferences of two upper limbs［(1.4±0.6)cm vs(1.0±0.6)cm] and the incidence of complications (31.6% vs 16.7%) between two groups (all P＞0.05). The rate of thrombus clearance for CDT was superior to pure anticoagulant therapy (89. 5% vs 50.0%, P＜0.05). At 6-month of follow-up, there was no significant difference in the venous patency rate between two groups (P＞0.05). Kaplan-Meier survival analysis and intergroup log-rank test showed that the venous patency time of overall follow-up ［(8.1±4.1) months] in CDT therapy was significantly better than that in pure anticoagulant therapy group (P<0.05). Conclusion CDT is safe and effective for secondary axillary-subclavian venous thrombosis in acute stage and has higher patency rate compared with pure anticoagulant therapy. In the patients combined with subclavian vein stenosis, angioplasty has a good short-term effect.