Thromb Haemost 2019; 119(08): 1365-1372
DOI: 10.1055/s-0039-1688828
Stroke, Systemic or Venous Thromboembolism
Georg Thieme Verlag KG Stuttgart · New York

Upper Extremity DVT versus Lower Extremity DVT: Perspectives from the GARFIELD-VTE Registry

Walter Ageno
1  Department of Medicine and Surgery, University of Insubria, Varese, Italy
Sylvia Haas
2  Department of Medicine, Technical University of Munich, Munich, Germany
Jeffrey I. Weitz
3  Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Ontario, Canada
Samuel Z. Goldhaber
4  Harvard Medical School, Harvard University, Boston, Massachusetts, United States
Alexander G. G. Turpie
5  Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Shinya Goto
6  Department of Medicine (Cardiology), Tokai University School of Medicine, Tokyo, Japan
Pantep Angchaisuksiri
7  Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Joern Dalsgaard Nielsen
8  Copenhagen University Hospital, Copenhagen, Denmark
Gloria Kayani
9  Thrombosis Research Institute, London, United Kingdom
Alfredo E. Farjat
9  Thrombosis Research Institute, London, United Kingdom
Audrey Zaghdoun
9  Thrombosis Research Institute, London, United Kingdom
Sebastian Schellong
10  Medical Division 2, Municipal Hospital Dresden-Friedrichstadt, Dresden, Germany
Henri Bounameaux
11  Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland
Lorenzo G. Mantovani
12  Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
Paolo Prandoni
13  Arianna Foundation on Anticoagulation, Bologna, Italy
Harald Darius
14  Vivantes Neukoelln Medical Center, Berlin, Germany
Ajay K. Kakkar
15  Thrombosis Research Institute and University College London, London, United Kingdom
› Author Affiliations
Further Information

Publication History

28 January 2019

29 March 2019

Publication Date:
10 June 2019 (online)


Upper extremity deep vein thrombosis (UEDVT) is less common than lower extremity DVT (LEDVT) and consequently less well characterized. This study compared clinical characteristics and 1-year outcomes between 438 UEDVT patients and 7,602 LEDVT patients recruited in the GARFIELD-VTE registry. UEDVT patients were significantly more likely to have a central venous catheter than those with LEDVT (11.5% vs. 0.5%; p < 0.0001), and had a higher rate of active cancer (16.2%) or recent hospitalization (19.4%) compared with LEDVT patients (8.7% and 11.2%, respectively). Nearly all patients with UEDVT and LEDVT were initiated on anticoagulant therapy, which was a direct oral anticoagulant in one-third individuals in both groups. At 3, 6, and 12 months, the proportion of UEDVT and LEDVT patients who were receiving anticoagulant therapy was 82.6 and 87.4%, 66.0 and 72.6%, and 45.7 and 54.6%, respectively. In the UEDVT and LEDVT groups, VTE recurrence rate was 4.0 (95% confidence interval [CI], 2.4–6.7) and 5.5 (95% CI, 4.9–6.1) per 100 person-years, respectively; major bleed was noted in 1.3 (95% CI, 0.6–3.2) and 1.6 (95% CI, 1.3–1.9) per 100 person-years and all-cause mortality in 9.7 (95% CI, 7.1–13.4) and 6.7 (95% CI, 6.1–7.3) per 100 person-years, respectively. Hence, risk of recurrence was similar in the two groups whereas all-cause mortality was significantly higher in the UEDVT group than the LEDVT group (p = 0.0338). This latter finding was likely due to the high prevalence of cancer in the UEDVT group.


The GARFIELD-VTE Registry is an independent academic research initiative sponsored by the Thrombosis Research Institute (London, United Kingdom) and supported by an unrestricted research grant from Bayer Pharma AG (Berlin, Germany).