Thromb Haemost 2012; 108(06): 1097-1108
DOI: 10.1160/TH12-05-0352
Review Article
Schattauer GmbH

Diagnosis and management of upper extremity deep-vein thrombosis in adults

Jonathan D. Grant
1   Division of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
,
Scott M. Stevens
2   Department of Medicine, Intermountain Medical Center, Murray, Utah, USA
3   Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
,
Scott C. Woller
2   Department of Medicine, Intermountain Medical Center, Murray, Utah, USA
3   Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
,
Edward W. Lee
4   Division of Interventional Radiology, Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
,
Stephen T. Kee
4   Division of Interventional Radiology, Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
,
David M. Liu
5   Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
,
Derek G. Lohan
6   Department of Radiology, Galway University Hospitals, Galway, Ireland
,
C. Gregory Elliott
2   Department of Medicine, Intermountain Medical Center, Murray, Utah, USA
3   Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
› Author Affiliations
Further Information

Publication History

Received: 01 June 2012

Accepted after major revision:30 August 2012

Publication Date:
30 November 2017 (online)

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Summary

Upper extremity deep-vein thrombosis (UEDVT) is common and can cause important complications, including pulmonary embolism and post-thrombotic syndrome. An increase in the use of central venous catheters, particularly peripherally inserted central catheters has been associated with an increasing rate of disease. Accurate diagnosis is essential to guide management, but there are limitations to the available evidence for available diagnostic tests. Anticoagulation is the mainstay of therapy, but interventional treatments may be considered in select situations. The risk of UEDVT may be reduced by more careful selection of patients who receive central venous catheters and by use of smaller catheters. Herein we review the diagnosis, management and prevention of UEDVT. Due to paucity of research, some principles are drawn from studies of lower extremity DVT. We present a practical approach to diagnosing the patient with suspected deep-vein thrombosis of the upper extremity.