Thrombectomy in Lemierre's Syndrome: A Systematic Literature Review.

Introduction: Lemierre's syndrome (LS) is a rare but potentially life-threatening condition characterized by septic thrombophlebitis of the internal jugular vein, typically following an oropharyngeal infection. First described in 1936, the syndrome was once considered a "forgotten disease" due to its rarity in the post-antibiotic era. However, recent decades have witnessed a modest resurgence in reported cases, attributed in part to increased clinical awareness, improved diagnostic techniques, and evolving microbial resistance patterns. Antibiotics and anticoagulation remain mainstay of treatment with a high rate of treatment response. However, there is a small subset of patients that fail standard treatment and instead clinically deteriorate necessitating prolonged antibiotic therapy. This cohort of patients typically has unexpected critical care unit admissions and prolonged hospital stays. Historically, these patients would undergo vessel ligation. Thrombectomy has been proposed as an alternative to surgical vessel ligation for treatment resistant LS. Materials and Methods: Using PubMed/MEDLINE and Scopus databases, we performed a comprehensive literature search on April 16, 2025, to identify studies relating to thrombectomy in Lemierre's Syndrome. Results: Four articles were found that fit inclusion criteria. Although limited by quantity, the studies found demonstrated that patients with treatment resistant disease usually had some clinical improvement after thrombectomy and on average had shorter intensive care unit and hospital stays. Conclusion: Thrombectomy use for treatment resistant LS is not well described in the literature. However, while not ideal or appropriate for every patient, there could exist a potential role for thrombectomy in patient with LS symptomology resistant to antibiotics and anticoagulation.