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J Reconstr Microsurg 2014; 30(04): 275-278
DOI: 10.1055/s-0033-1361845
Letter to the Editor: Short Reports
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Upper Extremity Deep Vein Thrombosis and Pulmonary Embolus after Radial Forearm Free Flap: A Case Report and Literature Review

Joshua Wood
1   Department of Otolaryngology/Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
,
Jon Ver Halen
2   Department of Plastic and Reconstructive Surgery, Baptist Cancer Center/Vanderbilt Ingram Cancer Center, Memphis, Tennessee
,
Sandeep Samant
1   Department of Otolaryngology/Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
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Publikationsverlauf

15. September 2013

06. Oktober 2013

Publikationsdatum:
07. Januar 2014 (online)

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Background

Deep vein thrombosis (DVT) and its associated complications such as pulmonary embolism (PE) are well-known causes of morbidity and mortality in the surgical intensive care unit settings. The presentation, diagnosis, and management of lower extremity DVT (LEDVT) are well documented in the literature. However, the same is not true of those that occur in the upper extremities.[1] Upper extremity DVT (UEDVT) are less common than LEDVT , and usually asymptomatic until their complications arise. Risk factors for UEDVT differ from those of LEDVT, and include presence of a central venous catheter, cancer, and immobility.[1] [2] The first line therapy for UEDVT is systemic anticoagulation with low molecular weight heparin and long-term vitamin K antagonist therapy. Although less than in LEDVT, there is significant morbidity and mortality related to UEDVT, including PE and postthrombotic syndrome. We present a case of UEDVT that occurred in a head and neck cancer patient following relative immobility subsequent to radial forearm free flap harvest from his left arm.

 

  • References

  • 1 Malinoski DJ, Ewing T, Patel MS , et al. The natural history of upper extremity deep venous thromboses in critically ill surgical and trauma patients: what is the role of anticoagulation?. J Trauma 2011; 71 (2) 316-321 , discussion 321–322
    CrossrefPubMedGoogle Scholar
  • 2 Lee JA, Zierler BK, Zierler RE. The risk factors and clinical outcomes of upper extremity deep vein thrombosis. Vasc Endovascular Surg 2012; 46 (2) 139-144
    CrossrefPubMedGoogle Scholar
  • 3 Martinelli I, Battaglioli T, Bucciarelli P, Passamonti SM, Mannucci PM. Risk factors and recurrence rate of primary deep vein thrombosis of the upper extremities. Circulation 2004; 110 (5) 566-570
    CrossrefPubMedGoogle Scholar
  • 4 Saseedharan S, Bhargava S. Upper extremity deep vein thrombosis. Int J Crit Illn Inj Sci 2012; 2 (1) 21-26
    CrossrefPubMedGoogle Scholar
  • 5 Prandoni P, Bernardi E. Upper extremity deep vein thrombosis. Curr Opin Pulm Med 1999; 5 (4) 222-226
    CrossrefPubMedGoogle Scholar
  • 6 Joffe HV, Kucher N, Tapson VF, Goldhaber SZ ; Deep Vein Thrombosis (DVT) FREE Steering Committee. Upper-extremity deep vein thrombosis: a prospective registry of 592 patients. Circulation 2004; 110 (12) 1605-1611
    CrossrefPubMedGoogle Scholar