In cancer patients, the average mortality rate is 18% at 3 months after the onset of UEDVT and 47% at 1 year after the onset.
It is recommended in the American College of Chest Physicians (ACCP) guideline that treatment of UEDVT be conducted on the basis of the treatment rationale for LEDVT, observational studies, and the results of studies on understanding of the natural history of UEDVT, since there have been no randomized controlled trials for the treatment of UEDVT .
We recently encountered a case of UEDVT in a patient who presented to our outpatient service with the chief complaints of left-sided neck pain and swelling.
Large epidemiologic studies have demonstrated that hypercoagulability is a risk factor for lower extremity DVT, but few data exist on the role of coagulation abnormalities in patients with primary UEDVT. The prevalence of clotting abnormalities in patients with primary UEDVT ranges from 8% to 43%.
Heron and colleagues (7) reported that 16 of 51 patients with at least one clotting abnormality had primary UEDVT. Factor V Leiden was found in 5 of those patients (20%).
Malignancy is also an important risk factor for UEDVT. (8,9) In patients with a DVT in an unusual location, age- and sex-appropriate cancer screenings are strongly recommended.
showed that PE occurring in cases of UEDVT is most likely to be related to UEDVT secondary to catheterization and primary UEDVT is rarely associated with PE .
(1) Bilateral UEDVT is an extremely rare condition and should raise the suspicion for TOS.
(3) Diagnosis of TOS causing UEDVT starts with US venous Doppler and is usually followed by venogram, which is considered the gold standard test.
There are no clear guidelines for patients at risk of UEDVT
associated with PICC.
Kabani et al (3) a study of 1,275 patients admitted to the surgical ICU over a 12-month period found that the incidence of UEDVT was higher than that of LEDVT (17% vs.
Primary UEDVT is a rare disorder (2 per 100 000 persons per year) (5).It includes effort thrombosis (Paget-Schroetter Syndrome) or idiopathic UEDVT.