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

Jonathan D. Grant; Scott M. Stevens; Scott C. Woller; Edward W. Lee; Stephen T. Kee; David M. Liu; Derek G. Lohan; C. Gregory Elliott

doi:10.1160/TH12-05-0352

Thrombosis and Haemostasis, Table of Contents

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

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

Abstract

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

Full Text

References

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