Review of deep vein thrombosis in upper extremities

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The prevalence of patients with DVT in upper extremities was 3.0% in the current large-scale real-world registry” Yamashita et al (2019).iv6

Abstract:

INTRODUCTION: There is a paucity of data on patients with deep vein thrombosis (DVT) in upper extremities.

MATERIALS AND METHODS: The COMMAND VTE Registry is a retrospective multicenter registry enrolling 3027 consecutive patients with acute symptomatic venous thromboembolism (VTE) in Japan. The current study population included 2498 patients with upper or lower extremities DVT.

RESULTS: There were 74 patients (3.0%) with upper extremities DVT and 2424 patients with lower extremities DVT. Patients with upper extremities DVT more often had active cancer (58%) and central venous catheter use (22%). The proportion of concomitant pulmonary embolism at diagnosis was lower in patients with upper extremities DVT than in those with lower extremities DVT (14% and 51%, P < 0.001). Discontinuation of anticoagulation therapy was more frequent in patients with upper extremities DVT (63.8% and 29.8% at 1-year, P < 0.001). The cumulative 3-year incidence of recurrent VTE was not different between the 2 groups (9.8% and 7.4%, P = 0.43). After adjusting confounders, the risks of upper extremities DVT relative to lower extremities DVT for recurrent VTE remained insignificant (HR 0.94, 95%CI 0.36-2.01, P = 0.89). CONCLUSIONS: The prevalence of patients with DVT in upper extremities was 3.0% in the current large-scale real-world registry. Patients with DVT in upper extremities more often had active cancer at diagnosis and central venous catheter use as a transient risk factor for VTE, and less often had concomitant PE. Patients with DVT in upper extremities had similar long-term risk for recurrent VTE as those with DVT in lower extremities despite shorter duration of anticoagulation.

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Reference:

Yamashita, Y., Morimoto, T., Amano, H., Takase, T., Hiramori, S., Kim, K., Oi, M., Akao, M., Kobayashi, Y., Toyofuku, M., Izumi, T., Tada, T., Chen, P.M., Murata, K., Tsuyuki, Y., Saga, S., Nishimoto, Y., Sasa, T., Sakamoto, J., Kinoshita, M., Togi, K., Mabuchi, H., Takabayashi, K., Yoshikawa, Y., Shiomi, H., Kato, T., Makiyama, T., Ono, K. and Kimura, T. (2019) Deep vein thrombosis in upper extremities: Clinical characteristics, management strategies and long-term outcomes from the COMMAND VTE Registry. Thrombosis Research. February 25th. .

doi: 10.1016/j.thromres.2019.02.029.

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