Diagnosis and management of upper extremity deep-vein thrombosis in adults (original) (raw)

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

Schattauer GmbH

Jonathan D. Grant

1Division of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA

Scott M. Stevens

2Department of Medicine, Intermountain Medical Center, Murray, Utah, USA

3Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA

,

Scott C. Woller

2Department of Medicine, Intermountain Medical Center, Murray, Utah, USA

3Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA

,

Edward W. Lee

4Division of Interventional Radiology, Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA

,

Stephen T. Kee

4Division of Interventional Radiology, Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA

,

David M. Liu

5Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

,

Derek G. Lohan

6Department of Radiology, Galway University Hospitals, Galway, Ireland

,

C. Gregory Elliott

2Department of Medicine, Intermountain Medical Center, Murray, Utah, USA

3Department 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)

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.

Keywords

Venous thrombosis - diagnosis management - deep-vein thrombosis - magnetic resonance - risk factors

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