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Semin Vasc Med 2001; 01(1): 105-110
DOI: 10.1055/s-2001-14547
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Upper Extremity Deep Vein Thrombosis: Risk Factors, Diagnosis, and Management

Enrico Bernardi, Andrea Piccioli, Antonio Marchiori, Bruno Girolami, Paolo Prandoni
  • Department of Medical and Surgical Sciences, 2nd Chair of Internal Medicine, University of Padua Medical School, Padua, Italy
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Publication History

Publication Date:
31 December 2001 (online)

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ABSTRACT

Upper extremity deep vein thrombosis (UEDVT) should no longer be regarded as an uncommon and benign disease, as previously reported. It is usually associated with risk factors, as central venous lines, malignancy, and coagulation defects; however, up to 20% of UEDVTs are apparently spontaneous. The clinical picture is characterized by swelling, pain, and functional impairment, albeit UEDVT may be completely asymptomatic. Objective testing is mandatory prior to instituting anticoagulation because the prevalence of UEDVT is less than 50% in symptomatic subjects, and compression ultrasound or color Doppler represents the preferred diagnostic methods. Up to 36% of the patients develop pulmonary embolism, which may be fatal; postthrombotic sequelae and recurrent thromboembolism are also frequent complications. Unfractionated or low-molecular-weight heparin followed by oral anticoagulation should be regarded as the treatment of choice; thrombolysis and surgery may be indicated in selected cases. Prophylaxis with low-dose heparin or low-dose warfarin is necessary whenever central venous catheters are positioned.

KEYWORD

Upper extremity deep vein thrombosis - compression ultrasonography - pulmonary embolism - postthrombotic syndrome - malignancy

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