Colour Doppler Sonographic Diagnosis of Upper Limb Venous Thromboses

Abstract

1. Upper limb venous thromboses are considered to be a rare event, but in large hospitals with a lot of patients who receive aggressive intravenous therapy the number of thromboses seem to increase. 2. We have analysed all the cases of upper limb venous thrombosis which occurred at the Essen University Hospital between the years of 1992-1996. All patients were examined using colour Doppler sonography. 3. Out of 827 patients that were examined, a thrombosis was diagnosed in 334 cases. The subclavian vein was involved in 69% of all thromboses. Isolated jugular vein thrombosis was found in 17% of the thromboses, combined thromboses of the jugular and subclavian vein in 19%. In 182 cases the patients were treated for primarily a malignant illness. In 96 cases we found an association with venous port-systems or central venous catheters. 4. More than 40,000 patients a year were treated at the university hospital. Considering this huge number of patients the thrombosis of the upper limb is still rare. The use of colour Doppler sonography allows an early and safe diagnosis of the thrombosis without straining the patients.

The prevalence of upper extremity deep venous thrombosis

“…[10] We diagnosed UEDVT in 89 out of 70,751 adult patients ≥20 years (0.13%), and we identified UEDVT, which represented 12% of all cases of DVT during this period, in hospitalized patients at an approximate rate of 1.3 per 1000 patients per year. The prevalence of UEDVT that we observed among hospitalized patients was slightly lower than that reported by Kröger et al [17] and Mustafa et al [8] A possible explanation for the lower UEDVT prevalence in our study could be that we reported only symptomatic UEDVT in a rather low number of patients with CVC. The frequency of UEDVT we reported probably grossly underestimates the true number of cases because imaging tests for UEDVT were always performed on symptomatic patients in our series.…”

“…[6,9,11,15] As the use of CVC and pacemaker wires has increased, their role in the etiology of UEDVT has become more prominent. [6][7][8][10][11][12]14,17] This association was clearly evident in the present study in which only 19% of our patients had CVC. In contrast, Kröger et al [17] and Mustafa et al [8] reported the use of CVC in 33% and 60% of patients with UEDVT, respectively.…”

“…[4,8,12,17] In fact, a hypercoagulable state has been described in patients with COPD. [33,34] Venous thromboembolism also occurs with increased frequency in patients with COPD during ARE.…”

“…[1] To our knowledge, the prevalence of symptomatic UEDVT among hospitalized patients has been previously evaluated. Two cases were reported per 1.000 hospital admissions by Kröger et al [17] in 1998. Also, Mustafa et al [8] recently reported that 0.19% of hospitalized adult patients had symptomatic UEDVT.…”

Primary Upper Extremity Deep Venous Thrombosis and Comorbidity: A Population-Based Nationwide Study in Sweden

“…Both the subclavian and axillary veins [1][2][3] and the brachial vein may be involved [4]. The frequency of UEDVT varies in different studies, and the proportion is 1-10% of all DVTs [5][6][7][8].…”