English Polski
Vol 25, No 2 (2019)
Review paper
Published online: 2019-05-23

open access

Page views 2393
Article views/downloads 1025
Get Citation

Connect on Social Media

Connect on Social Media

Upper extremity deep vein thrombosis: pathogenesis and treatment

Piotr Pukacki1, Robert Juszkat1, Maciej Błaszyk1, Łukasz Dzieciuchowicz1, Zbigniew Krasiński1
Acta Angiologica 2019;25(2):115-119.

Abstract

Upper extremity deep vein thrombosis (UEDVT) may be the first manifestation of venous thoracic outlet syndrome
(VTOS). It primarily affects young, physically active people. The clinical findings depend on the degree
of obstruction of the subclavian vein. Correct diagnosis — aided by various imaging modalities — as well as
rapid initiation of local thrombolytic therapy, surgical decompression of the thoracic outlet (when indications
are present), and the immediate initiation of anticoagulation therapy aim at successfully restoring the patient’s
quality of life.

Article available in PDF format

View PDF Download PDF file

References

  1. Vemuri C, Salehi P, Benarroch-Gampel J, et al. Diagnosis and treatment of effort-induced thrombosis of the axillary subclavian vein due to venous thoracic outlet syndrome. J Vasc Surg Venous Lymphat Disord. 2016; 4(4): 485–500.
  2. Lee JA, Zierler BK, Zierler RE. The risk factors and clinical outcomes of upper extremity deep vein thrombosis. Vasc Endovascular Surg. 2012; 46(2): 139–144.
  3. “Imaging in Deep Venous Thrombosis of the Upper Extremity: Practice Essentials, Radiography, Computed Tomography,” Sep. 2018.
  4. Heil J, Miesbach W, Vogl T, et al. Deep Vein Thrombosis of the Upper Extremity. Dtsch Arztebl Int. 2017; 114(14): 244–249.
  5. Carlon TA, Sudheendra D. Interventional Therapy for Upper Extremity Deep Vein Thrombosis. Semin Intervent Radiol. 2017; 34(1): 54–60.
  6. Klitfod L, Broholm R, Baekgaard N. Deep venous thrombosis of the upper extremity. A review. Int Angiol. 2013; 32(5): 447–452.
  7. Pukacki F, ZielińskI M, Oszkinis G, et al. 30 lat doświadczeń w leczeniu zespołu górnego otworu klatki piersiowej 2012, vol. XXXXXXXXXXXXXX. 2012; 18(Suppl. A): A53.
  8. Illig KA, Doyle AJ. A comprehensive review of Paget-Schroetter syndrome. J Vasc Surg. 2010; 51(6): 1538–1547.
  9. Thompson RW. Comprehensive management of subclavian vein effort thrombosis. Semin Intervent Radiol. 2012; 29(1): 44–51.
  10. Peet RM, Henriksen JD, Anderson TP, et al. Thoracic-outlet syndrome: evaluation of a therapeutic exercise program. Proc. Staff Meet. Mayo Clin. 1956; 31(9): 281–287.
  11. Archie M, Rigberg D. Vascular TOS-Creating a Protocol and Sticking to It. Diagnostics (Basel). 2017; 7(2).
  12. de León RA, Chang DC, Hassoun HT, et al. Multiple treatment algorithms for successful outcomes in venous thoracic outlet syndrome. Surgery. 2009; 145(5): 500–507.
  13. Moore R, Wei Lum Y. Venous thoracic outlet syndrome. Vasc Med. 2015; 20(2): 182–189.
  14. Vazquez FJ, Paulin P, Poodts D, et al. Preferred management of primary deep arm vein thrombosis. Eur J Vasc Endovasc Surg. 2017; 53(5): 744–751.
  15. Urbanek T, Ziaja D, Kwiecień A, et al. Występowanie zespołu uciskowego górnego otworu klatki piersiowej (TOS) w populacji w wieku 19-26 lat. Chir Pol . 2008 ; 10(1): 8–15.
  16. Chen H, Doornbos N, Williams K, et al. Physiologic variations in venous and arterial hemodynamics in response to postural changes at the thoracic outlet in normal volunteers. Ann Vasc Surg. 2014; 28(7): 1583–1588.
  17. Pukacki F, Zieliński M, Juszkat R, et al. Doświadczenia własne w leczeniu postaci żylnej górnego otworu klatki piersiowe. XXXXXXXX. 2005 ; 11(1): 86.
  18. Zucker EJ, Ganguli S, Ghoshhajra BB, et al. Imaging of venous compression syndromes. Cardiovasc Diagn Ther. 2016; 6(6): 519–532.
  19. Kärkkäinen JM. Pharmacomechanical thrombectomy in Paget-Schroetter syndrome. Cardiovasc Intervent Radiol Sep. 2016; 39(9): 1272–1279.
  20. Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST Guideline and Expert Panel Report. Chest. 2016; 149(2): 315–352.
  21. Hobeika C, Meziane A, Sands MJ, et al. Paget-Schroetter syndrome: an uncommon cause of pulmonary embolic disease. J Thorac Imaging. 2010; 25(1): 1–3.
  22. Molina JE, Hunter DW, Dietz CA. Paget-Schroetter syndrome treated with thrombolytics and immediate surgery. J Vasc Surg. 2007; 45(2): 328–334.
  23. Siracuse JJ, Johnston PC, Jones DW, et al. Infraclavicular first rib resection for the treatment of acute venous thoracic outlet syndrome. J Vasc Surg Venous Lymphat Disord. 2015; 3(4): 397–400.
  24. Hussain MA, Aljabri B, Al-Omran M. Vascular Thoracic Outlet Syndrome. Semin Thorac Cardiovasc Surg. 2016; 28(1): 151–157.
  25. Freischlag J. Venous thoracic outlet syndrome: transaxillary approach. Operative Techniques in General Surgery. 2008; 10(3): 122–130.
  26. Urschel HC, Patel AN. Surgery remains the most effective treatment for Paget-Schroetter syndrome: 50 years' experience. Ann Thorac Surg. 2008; 86(1): 254–60; discussion 260.
  27. Machleder H. The anterior scalene muscle in thoracic outlet compression syndrome. Archives of Surgery. 1986; 121(10): 1141.
  28. Chang KZ, Likes K, Demos J, et al. Routine venography following transaxillary first rib resection and scalenectomy (FRRS) for chronic subclavian vein thrombosis ensures excellent outcomes and vein patency. Vasc Endovascular Surg. 2012; 46(1): 15–20.
  29. Rodriguez HE, Yao ST, Pearce WH. The ischemic extremity: new findings and treatment. PMPH-USA. 2010.
  30. Molina JE, Hunter DW, Dietz CA. Protocols for Paget-Schroetter syndrome and late treatment of chronic subclavian vein obstruction. Ann Thorac Surg. 2009; 87(2): 416–422.