S M Bleker1, N van Es1, A Kleinjan1, H R Büller1, P W Kamphuisen2, A Aggarwal3, J Beyer-Westendorf4, G Camporese5, B Cosmi6, T Gary7, A Ghirarduzzi8, K Kaasjager9, T Lerede10, P Marschang11, K Meijer2, H-M Otten12, E Porreca13, M Righini14, P Verhamme15, S van Wissen16, M Di Nisio1,13. 1. Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands. 2. University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. 3. Veterans Affairs Medical Center, George Washington University, Washington, DC, USA. 4. Division 'Thrombosis Research' and Division 'Angiology', Dresden University Clinic, Dresden, Germany. 5. University Hospital of Padova, Padova, Italy. 6. University of Bologna, Bologna, Italy. 7. Abteilung für Angiologie, Medical University, Graz, Austria. 8. Department of Internal Medicine, Company-Institute for Hospitalization and Care Scientific - Arcispedale Santa Maria Nova, Reggio Emilia, Italy. 9. University Medical Center Utrecht, Utrecht, the Netherlands. 10. USC Immunoematologia e Medicina Transfusionale, Emostasi e Trombosi, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy. 11. Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria. 12. Slotervaart Hospital, Amsterdam, the Netherlands. 13. Dipartimento di Medicina e Scienze dell'Invecchiamento, Università 'G. D'Annunzio', Chieti, Italy. 14. Geneva University Hospital, Geneva, Switzerland. 15. Centre for Molecular and Vascular Biology, University Hospital Leuven, Leuven, Belgium. 16. Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
Abstract
UNLABELLED: Essentials Few data exist on outcome of upper extremity deep and superficial vein thrombosis (UEDVT and UESVT). We followed 102 and 55 patients with UEDVT or UESVT, respectively, for a median of 3.5 years. Risk of recurrent venous thromboembolism was low in both diseases, and the mortality high. Postthrombotic symptoms were infrequent and cancer patients had a higher risk of recurrent VTE. SUMMARY: Background There is scant information on the optimal management and clinical outcome of deep and superficial vein thrombosis of the upper extremity (UEDVT and UESVT). Objectives To explore treatment strategies and the incidence of recurrent venous thromboembolism (VTE), mortality, postthrombotic symptoms, and bleeding in patients with UEDVT and UESVT and to assess the prognosis of cancer patients with UEDVT. Patients/methods Follow-up of patients with UEDVT or UESVT, who were enrolled previously in a diagnostic management study. Results We followed 102 and 55 patients with UEDVT and UESVT, respectively, both for a median of 3.5 years. Anticoagulant treatment was started in 100 patients with UEDVT (98%) and in 40 (73%) with UESVT. Nine patients with UEDVT (9%) developed recurrent VTE, 26 (26%) died, 6 (8%) of 72 patients had moderate postthrombotic symptoms, and 5 (5%) experienced major bleeding. One patient with UESVT had a recurrent VTE, 18 (33%) died, none had moderate postthrombotic symptoms, and none had major bleeding. Of the cancer patients with UEDVT, 18% had recurrent VTE vs. 7.5% in non-cancer patients (adjusted hazard ratio 2.2, 95%CI 0.6-8.2). The survival rate was 50% in cancer patients with UEDVT vs. 60% in those without (adjusted HR 0.8, 95%CI 0.4-1.4). Conclusions The risk of recurrent VTE was low in patients with UEDVT, and negligible for UESVT. Mortality was high for both diseases. Postthrombotic symptoms were infrequent and mild. Anticoagulant therapy of UEDVT carried a substantial risk of major bleeding. Cancer patients had a significant risk of recurrent VTE.
UNLABELLED: Essentials Few data exist on outcome of upper extremity deep and superficial vein thrombosis (UEDVT and UESVT). We followed 102 and 55 patients with UEDVT or UESVT, respectively, for a median of 3.5 years. Risk of recurrent venous thromboembolism was low in both diseases, and the mortality high. Postthrombotic symptoms were infrequent and cancerpatients had a higher risk of recurrent VTE. SUMMARY: Background There is scant information on the optimal management and clinical outcome of deep and superficial vein thrombosis of the upper extremity (UEDVT and UESVT). Objectives To explore treatment strategies and the incidence of recurrent venous thromboembolism (VTE), mortality, postthrombotic symptoms, and bleeding in patients with UEDVT and UESVT and to assess the prognosis of cancerpatients with UEDVT. Patients/methods Follow-up of patients with UEDVT or UESVT, who were enrolled previously in a diagnostic management study. Results We followed 102 and 55 patients with UEDVT and UESVT, respectively, both for a median of 3.5 years. Anticoagulant treatment was started in 100 patients with UEDVT (98%) and in 40 (73%) with UESVT. Nine patients with UEDVT (9%) developed recurrent VTE, 26 (26%) died, 6 (8%) of 72 patients had moderate postthrombotic symptoms, and 5 (5%) experienced major bleeding. One patient with UESVT had a recurrent VTE, 18 (33%) died, none had moderate postthrombotic symptoms, and none had major bleeding. Of the cancerpatients with UEDVT, 18% had recurrent VTE vs. 7.5% in non-cancerpatients (adjusted hazard ratio 2.2, 95%CI 0.6-8.2). The survival rate was 50% in cancerpatients with UEDVT vs. 60% in those without (adjusted HR 0.8, 95%CI 0.4-1.4). Conclusions The risk of recurrent VTE was low in patients with UEDVT, and negligible for UESVT. Mortality was high for both diseases. Postthrombotic symptoms were infrequent and mild. Anticoagulant therapy of UEDVT carried a substantial risk of major bleeding. Cancerpatients had a significant risk of recurrent VTE.
Authors: Jan Heil; Wolfgang Miesbach; Thomas Vogl; Wolf O Bechstein; Alexander Reinisch Journal: Dtsch Arztebl Int Date: 2017-04-07 Impact factor: 5.594
Authors: Scott C Woller; Scott M Stevens; Stacy A Johnson; Joseph R Bledsoe; Brian Galovic; James F Lloyd; Emily L Wilson; Brent Armbruster; R Scott Evans Journal: Res Pract Thromb Haemost Date: 2019-05-13
Authors: Grzegorz J Kwiecien; Demetrius M Coombs; Nicholas Sinclair; Brian R Gastman; Bahar Bassiri Gharb; Antonio Rampazzo Journal: Plast Reconstr Surg Glob Open Date: 2020-12-21