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Interventional Therapy for Upper Extremity Deep Vein Thrombosis.

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Summary

Upper extremity deep vein thrombosis (UEDVT) is rising, with similar risks to lower extremity deep vein thrombosis (LEDVT). This review covers UEDVT treatment options and patient management strategies.

Keywords:
Paget-Schroetter syndromeinterventional radiologypharmacomechanical thrombectomythrombolysisupper extremity deep vein thrombosis

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Area of Science:

  • Vascular Medicine
  • Interventional Cardiology

Background:

  • Deep vein thrombosis (DVT) in the upper extremity (UEDVT) accounts for approximately 10% of all DVTs.
  • The incidence of UEDVT is increasing, largely attributed to the growing use of peripherally inserted central catheters.
  • UEDVT shares similar severe sequelae with lower extremity deep vein thrombosis (LEDVT), including postthrombotic syndrome and pulmonary embolism.

Purpose of the Study:

  • To review the evidence for current interventional treatment options for UEDVT.
  • To outline a clinical approach for managing patients with acute UEDVT.
  • To address the lack of randomized trials defining optimal UEDVT management.

Main Methods:

  • Review of existing literature on UEDVT treatment.
  • Analysis of single-center studies and extrapolation from LEDVT research.
  • Description of interventional treatment modalities and patient management strategies.

Main Results:

  • Multiple interventional treatment options exist for UEDVT.
  • These interventions may potentially reduce the incidence of UEDVT sequelae.
  • Optimal management strategies are often based on limited evidence and LEDVT data.

Conclusions:

  • There is a need for randomized trials to establish optimal UEDVT management.
  • Current management relies on available evidence, smaller studies, and LEDVT research.
  • Systemic anticoagulation combined with interventional options offers potential benefits for UEDVT patients.