Upper Extremity Deep Vein Thrombosis: Symptoms, Diagnosis, and Treatment

作者：Mustafa Jaber; Asher Ilan; Sthoeger Zev^*

来源：Israel Medical Association Journal, 2018, 20(1): 53-57.

• upper extremity deep vein thrombosis (UEDVT)
• central intravenous catheter
• thoracic outlet anatomic abnormality
• thrombolysis
• pharmacomechanical thrombectomy

Upper extremity deep vein thrombosis (UEDVT) is defined as thrombosis of the deep venous system (subclavian, axillary, brachial, ulnar, and radial veins), which drains the upper extremities. It can be caused by thoracic outlet anatomic obstruction, such as Paget-Schroetter syndrome, (primary) or by central intravenous catheters (secondary). UEDVT may be asymptomatic, or present with acute severe pain and arm swelling. Clinical suspicion should be confirmed by diagnostic imaging procedures such as duplex ultrasound, computed tomogrephy scan, or magnetic resonance imaging. UEDVT is managed by anticoagulant treatment. In addition to that, early thrombolysis aimed at preventing post:deep vein thrombosis syndrome and thoracic outlet decompression surgery should be given to patients with primary UEDVT. Anticoagulation without thrombolysis is the treatment of choice for patients with catheter related thrombosis. Mandatory functioning catheters can remain in place with anticoagulant treatment. All other catheters should be immediately removed. The management of patients with UEDVT requires an experience multidisciplinary team comprised of internists, radiologists, hematologists,and vascular surgeons. Understanding the risk factors for the development of UEDVT, the diagnostic procedures, and the treatment modalities win. improve the outcome of those patients.

• 出版日期2018-1