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Venous Duplex Ultrasound of the Upper Extremities

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Noninvasive Vascular Diagnosis

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Abstract

Upper extremity imaging is increasing. The number of DVTs on upper extremity imaging has increased with the use of PIC lines. Secondary DVTs are more common than primary DVTs involving the upper extremity. UEDVT may be the source of PE, some of which may be fatal. Anatomic variations are very common in the venous system. Duplicate venous symptoms, lack of technological expertise, median nerve in transverse view, incorrect gain settings, patient positioning, and incorrect probe pressure or selection may all result in artifacts. Patients with UEDVTs are younger, leaner, and presented with edema more commonly than LE DVT patients. UEDVTs should not be considered a benign event. Optimal treatment goals involve prevention of propagation and to reduce the risk of secondary events. Maintenance of venous patency is mandatory. Multimodal therapy is increasing in use, and treatment of UE is evolving.

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Acknowledgments

I would like to acknowledge Feliks Bankin, Angela N Fellner, PhD, and the Good Samaritan Hospital Library staff for their assistance in preparation of this chapter.

Author information

Authors and Affiliations

  1. Department of Vascular Surgery, Good Samaritan Outpatient Center, 6350 Glenway Ave, Cincinnati, OH, 45211, USA

    Joann M. Lohr MD, FACS, RVT

  2. Quality Vascular Imaging, Inc., Virtual Vein Center, 4120 Woodmere Park Blvd, Venice, FL, 34293, USA

    Jean M. White-Melendez RVT, RPhS, FSVU

Authors
  1. Joann M. Lohr MD, FACS, RVT
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  2. Jean M. White-Melendez RVT, RPhS, FSVU
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Corresponding author

Correspondence to Joann M. Lohr MD, FACS, RVT .

Editor information

Editors and Affiliations

  1. Charleston, West Virginia, USA

    Ali F. AbuRahma

Review Questions

Review Questions

  1. 1.

    UEDVTs account for what percent of all DVTs?

    1. a.

      5%

    2. b.

      10%

    3. c.

      15%

    4. d.

      20%

  2. 2.

    Secondary DVTs of UE are more common than primary DVTs.

    1. a.

      True

    2. b.

      False

  3. 3.

    Fatal pulmonary emboli do not arise from UEDVT.

    1. a.

      True

    2. b.

      False

  4. 4.

    Which of the following is not a superficial vein of the UE?

    1. a.

      Basilic vein

    2. b.

      Cephalic vein

    3. c.

      Brachial vein

    4. d.

      External jugular vein

  5. 5.

    Too much probe pressure may result in falsely increased diameter measurements when performing vein mapping.

    1. a.

      True

    2. b.

      False

Answer Key

1.b

2.a

3.b

4.c

5.a

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Lohr, J.M., White-Melendez, J.M. (2017). Venous Duplex Ultrasound of the Upper Extremities. In: AbuRahma, A. (eds) Noninvasive Vascular Diagnosis. Springer, Cham. https://doi.org/10.1007/978-3-319-54760-2_42

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