Upper limb DVT thrombolysis

Upper limb DVT thrombolysis. This 18 year old woman developed sudden onset left upper limb swelling. Doppler ultrasound confirmed a DVT of the subclavian and axillary vein, and the patient was referred for thrombolysis. The left brachial vein was cannulated under ultrasound guidance. Contrast injection on image (a) shows a large filling defect in the axillary vein (arrow), representing the thrombus. A thrombolysis catheter was advanced into the occluded vein (b, arrow) and thrombolysis with tPA (tissue plasminogen activator) was commenced. Venogram performed the next day (c) shows complete resolution of the thrombus.