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Updated: Sep 9, 2026
Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
Clinical Outcomes of Upper-Extremity Deep Vein Thrombosis According to Cancer Status and Catheter Association: A
Philippe Debourdeau1, Olivier Espitia2, Lucia Mazzolai3
1Department of Supportive Care in Oncology, Hôpital Joseph Imbert, Arles, France.
Background:
Upper-extremity deep vein thrombosis (UEDVT) is increasingly diagnosed because of the widespread use of venous catheters, particularly in patients with cancer. However, its clinical course and the optimal duration of anticoagulant therapy remain uncertain.
Methods:
We analyzed 4979 patients with symptomatic isolated UEDVT enrolled in the Registro Informatizado de la Enfermedad TromboEmbólica, including 1383 patients with cancer and catheter-associated UEDVT, 599 with cancer and noncatheter-associated UEDVT, 921 without cancer and catheter-associated UEDVT, and 2076 without cancer and noncatheter-associated UEDVT. Outcomes included recurrent deep vein thrombosis, symptomatic pulmonary embolism, major bleeding, and all-cause mortality during anticoagulation and after treatment discontinuation. Competing-risk regression was used for thrombotic and bleeding outcomes, and Cox regression for mortality.
Results:
Catheter-associated UEDVT was more frequent among patients with cancer than among those without cancer (70% vs 35%). Among patients with cancer, catheter-associated UEDVT was associated with lower all-cause mortality than noncatheter-associated UEDVT (22.6 vs 55.9 deaths per 100 patient-years; adjusted hazard ratio 0.39; 95% CI 0.31-0.49) and lower recurrent venous thromboembolism (VTE) rates (6.27 vs 9.60 per 100 patient-years). Among patients without cancer, catheter-associated UEDVT was associated with higher mortality (10.7 vs 4.32 deaths per 100 patient-years) and major bleeding (2.49 vs 0.61 per 100 patient-years), whereas recurrent VTE rates were similar irrespective of catheter status. Across all 4 groups, recurrent VTE remained infrequent after anticoagulation discontinuation.
Conclusions:
Clinical outcomes of UEDVT differ according to both cancer status and catheter association. The persistently low recurrence rates after anticoagulation discontinuation, particularly in catheter-associated UEDVT, support an individualized approach to anticoagulation duration.
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Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above the...