Upper-extremity deep venous thrombosis and pulmonary embolism. A prospective study

Area of Science:

• Vascular Medicine
• Diagnostic Imaging
• Pulmonology

Background:

• Deep venous thrombosis (DVT) of the upper extremity is less common than lower extremity DVT.
• Pulmonary embolism (PE) is a known complication of DVT, but its prevalence in upper extremity DVT is not well-established.
• Catheter-related DVT is a frequent cause of upper extremity DVT.

Purpose of the Study:

• To determine the prevalence of pulmonary embolism (PE) in patients diagnosed with upper extremity deep venous thrombosis (DVT).
• To compare the risk of PE in primary upper extremity DVT versus catheter-related DVT.

Main Methods:

• Prospective evaluation of 30 consecutive patients with confirmed upper extremity DVT.
• Ventilation-perfusion (V/Q) lung scans performed on admission for all but one critically ill patient.
• Classification of DVT as primary or catheter-related.

Main Results:

• Pulmonary embolism (PE) was diagnosed in 4 out of 20 patients with catheter-related DVT.
• Only 1 out of 10 patients with primary upper extremity DVT showed indeterminate lung scan findings suggestive of PE.
• One critically ill patient with catheter-related DVT died from massive PE.

Conclusions:

• Pulmonary embolism (PE) is a notable complication of upper extremity deep venous thrombosis (DVT).
• Patients with catheter-related DVT appear to have a higher risk of developing PE compared to those with primary DVT.
• V/Q lung scans are valuable in assessing PE risk in this patient population.