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Lee AY, Ginsberg JS. Venous Thrombosis of the Upper Extremities. Curr Treat Options Cardiovasc Med. 2001;3(3):207-214doi: 10.1007/s11936-001-0039-0.
Lee, A. Y., & Ginsberg, J. S. (2001). Venous Thrombosis of the Upper Extremities. Current treatment options in cardiovascular medicine, 3(3), 207-214. https://doi.org/10.1007/s11936-001-0039-0
Lee, Agnes Y. Y., and Ginsberg, Jeffrey S.. "Venous Thrombosis of the Upper Extremities." Current treatment options in cardiovascular medicine vol. 3,3 (2001): 207-214. doi: https://doi.org/10.1007/s11936-001-0039-0
Lee AY, Ginsberg JS. Venous Thrombosis of the Upper Extremities. Curr Treat Options Cardiovasc Med. 2001 Jun;3(3):207-214. doi: 10.1007/s11936-001-0039-0. PMID: 11341866.
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Curr Treat Options Cardiovasc Med. 2001 Jun;3(3):207-214. doi: 10.1007/s11936-001-0039-0.

Venous Thrombosis of the Upper Extremities.

Current treatment options in cardiovascular medicine

Agnes Y. Y. Lee, Jeffrey S. Ginsberg

Affiliations

  1. Division of Hematology and Thromboembolism, Department of Medicine, Hamilton Health Sciences Corporation, Henderson Site, 711 Concession Street, Hamilton, Ontario, Canada L8V 1C3. [email protected]

PMID: 11341866 DOI: 10.1007/s11936-001-0039-0

Abstract

The goals of treating patients with upper-extremity deep vein thrombosis (UEDVT) are to relieve acute symptoms of venous occlusion, prevent pulmonary embolism, reduce the likelihood of recurrent thrombosis, and avoid the development of postphlebitic syndrome. Although the details of management differ, depending on the underlying cause and precipitating factors, anticoagulant therapy should be the first-line treatment of choice in all cases. For patients with primary or idiopathic UEDVT (Paget-von Schroetter syndrome), aggressive measures including catheter-directed thrombolysis, vascular procedures (eg, balloon angioplasty, stenting, filter), and surgical maneuvers (eg, first rib resection) have been advocated by some surgeons, but none of these high-risk interventions has been evaluated properly in prospective controlled trials. In contrast, for patients with catheter-associated central venous thrombosis (CACVT), or other secondary cases of UEDVT, many clinicians simply withdraw the catheter and avoid anticoagulant therapy. Because well-designed clinical trials are lacking, recommendations about the management of UEDVT are derived from descriptive studies and case series. Until further research identifies the natural history and optimum management of UEDVT, it seems reasonable to base treatment on anticoagulant regimens with proven effectiveness in lower-extremity deep vein thrombosis (LEDVT). The use of additional intervention(s) should be reserved for carefully selected patients.

References

  1. Arch Intern Med. 1991 Oct;151(10):1934-43 - PubMed
  2. Arch Surg. 1970 Dec;101(6):792-6 - PubMed
  3. Ann Intern Med. 1999 May 18;130(10):789-99 - PubMed
  4. Thromb Haemost. 1999 Sep;82(3):1008-10 - PubMed
  5. Radiology. 1999 Jan;210(1):53-8 - PubMed
  6. J Vasc Surg. 1997 Nov;26(5):853-60 - PubMed
  7. Am J Med. 2000 Feb 15;108(3):251-5 - PubMed
  8. Am J Surg. 1990 Feb;159(2):208-10; discussion 210-1 - PubMed
  9. J Vasc Interv Radiol. 1996 Nov-Dec;7(6):845-51 - PubMed
  10. Prog Cardiovasc Dis. 1991 Nov-Dec;34(3):193-204 - PubMed
  11. Semin Vasc Surg. 1998 Jun;11(2):91-5 - PubMed
  12. Circulation. 1970 May;41(5 Suppl):II147-51 - PubMed
  13. Chest. 2001 Jan;119(1 Suppl):176S-193S - PubMed
  14. Arch Intern Med. 1997 Jan 13;157(1):57-62 - PubMed
  15. Ann Intern Med. 1960 Jun;52:1337-43 - PubMed
  16. Thromb Haemost. 1994 Oct;72 (4):548-50 - PubMed
  17. Arch Intern Med. 1997 Feb 10;157(3):289-94 - PubMed
  18. J Vasc Surg. 1993 Feb;17 (2):305-15; discussion 316-7 - PubMed
  19. Am J Surg. 1986 Aug;152(2):179-84 - PubMed
  20. Curr Opin Pulm Med. 1999 Jul;5(4):222-6 - PubMed
  21. Can J Surg. 1998 Feb;41(1):13-25 - PubMed

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