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Upper Extremity Deep Vein Thrombosis

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Current Management of Venous Diseases

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Abstract

Upper extremity deep vein thrombosis (UEDVT) accounts for up to 10% of all deep vein thrombosis. The incidence is increasing, which is mostly due to extensive use of central venous catheters (CVCs). UEDVT often presents with unilateral swelling and pain but may be asymptomatic. Several factors increase the risk of UEDVT, of which cancer and CVCs are the strongest risk factors. To prevent acute complications and long-term sequelae of UEDVT, such as pulmonary embolism and the post-thrombotic syndrome, a prompt diagnosis and effective and safe therapy are crucial. Objective imaging through venography or compression ultrasonography is at present the cornerstone of diagnosis, despite its moderate efficiency. Current treatment options for UEDVT are anticoagulant therapy, thrombolytic therapy, mechanical catheter interventions, first rib resection in case of thoracic outlet syndrome, and vena cava filter placement. Routine thromboprophylaxis in patients with a CVC is currently not recommended.

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Abbreviations

CI:

Confidence interval

CT:

Computed tomography

CVC:

Central venous catheter

DOAC:

Direct oral anticoagulant

DVT:

Deep vein thrombosis

LMWH:

Low-molecular-weight heparin

OR:

Odds ratio

PE:

Pulmonary embolism

PTS:

Post-thrombotic syndrome

TOS:

Thoracic outlet syndrome

UEDVT:

Upper extremity deep vein thrombosis

UFH:

Unfractionated heparin

VCF:

Vena cava filter

VKA:

Vitamin K antagonist

VTE:

Venous thromboembolism

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Acknowledgments

We would like to acknowledge Marcello Di Nisio for his critical revision of the manuscript for intellectual content.

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Authors and Affiliations

  1. Department of Vascular Medicine, Academic Medical Center, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands

    Suzanne M. Bleker MD, PhD, Noémie Kraaijpoel MD & Harry R. Büller MD, PhD

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  1. Suzanne M. Bleker MD, PhD
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  2. Noémie Kraaijpoel MD
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  3. Harry R. Büller MD, PhD
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Correspondence to Suzanne M. Bleker MD, PhD .

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  1. Section of Vascular Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA

    Cassius Iyad Ochoa Chaar

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Bleker, S.M., Kraaijpoel, N., Büller, H.R. (2018). Upper Extremity Deep Vein Thrombosis. In: Chaar, C. (eds) Current Management of Venous Diseases . Springer, Cham. https://doi.org/10.1007/978-3-319-65226-9_27

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