Deep Venous Thrombosis of the Upper and Lower Extremity

Hattab, Yousef; Küng, Sarah; Fasanya, Adebayo; Ma, Kiet; Singh, Anil; Dumont, Tiffany

doi:10.1097/cnq.0000000000000165

Cited by 19 publications

(13 citation statements)

References 28 publications

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“…Deep vein thrombosis (DVT) consists of upper‐extremity deep venous thrombosis (UEDVT) and lower‐extremity deep venous thrombosis (LEDVT), and represents the formation of blood clots within the deep veins of the affected extremities . Acute LEDVT happens when large veins are obstructed by thrombi and its clinical manifestations are swelling and pain that can cause morbidity and mortality without treatment .…”

Section: Introductionmentioning

confidence: 99%

Overexpressed microRNA‐103a‐3p inhibits acute lower‐extremity deep venous thrombosis via inhibition of CXCL12

et al. 2019

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Studies have shown that microRNAs (miRNAs) participate in almost all pathological and physiological processes including acute lower‐extremity deep venous thrombosis (LEDVT). Here, this study was designed to elucidate the possible function of miR‐103a‐3p in acute LEDVT. Expression of miR‐103a‐3p and chemokine C‐X‐C motif ligand 12 (CXCL12) was initially quantified in plasma collected from 81 LEDVT patients. Then LEDVT mouse models were established by injection with 3% sodium pentobarbital. The interaction between miR‐103a‐3p and CXCL12 was identified by dual‐luciferase reporter gene assay. After gain‐ and loss‐of‐function studies, interleukin‐6 (IL‐6) and IL‐8 and tissue factor (TF) levels, and expression of plasminogen activator inhibitors (PAIs), von Willebrand factor (vWF), thromboxane A2 (TH‐A2), F4/80, IL‐12, Arginase‐1 (Arg‐1) and CD206 were determined using enzyme‐linked immunosorbent assay (ELISA), reverse transcription quantitative polymerase chain reaction (RT‐qPCR) and western blot analysis, respectively. miR‐103a‐3p was downregulated, while CXCL12 was upregulated in patients and mice with LEDVT. miR‐103a‐3p targets CXCL12 and inhibited its expression. Overexpressed miR‐103a‐3p or downregulated CXCL12 decreased expression of IL‐6, IL‐8, TF, PAIs, vWF, TH‐A2, M1 markers (IL‐6 and IL‐12), yet increased expression of M2 markers (Arg‐1 and CD206) in LEDVT mice. Additionally, upregulated miR‐103a‐3p or silencing CXCL12 suppressed thrombosis in LEDVT mice. However, overexpression of CXCL12 reversed the tendency mentioned above. Altogether, miR‐103a‐3p can potentially downregulate CXCL12 expression to disrupt inflammatory response and thrombosis, ultimately preventing the development of LEDVT. Our findings underscore a possible alternative therapeutic strategy to limit LEDVT.

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Section: Introductionmentioning

confidence: 99%

Overexpressed microRNA‐103a‐3p inhibits acute lower‐extremity deep venous thrombosis via inhibition of CXCL12

et al. 2019

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“…DVT is formed when the mechanism that makes the body easy to coagulate is not hindered, or when the mechanism of decomposing blood clots is overloaded [36]. On the other hand, PICC occupies nearly half of the inner diameter of the vein, resulting in local blood ow slowing down, which can produce micro venous thrombosis, activate the coagulation system in the process of re ux, so as to produce a larger range of deep venous thrombosis [36]. We have reason to believe that the operation of PICC insertion itself or the existence of PICC leads to the general increase of D-dimer value.…”

Section: Discussionmentioning

confidence: 99%

Peripherally Inserted Central Venous Catheter in Upper Extremities Could be a Risk for Deep Vein Thrombosis in Lower Extremities and D-Dimer in Neurology Department

Liu

Zeng

et al. 2020

Preprint

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Background: With the in-depth study of Peripherally Inserted Central venous Catheter (PICC) related venous thrombosis, it is found that the incidence of lower extremity deep venous thrombosis (LEDVT) in patients with PICC in upper extremities is higher than that in patients without PICC . However, there is no explanation for this clinical phenomenon that PICC related venous thrombosis seems to have exceeded the range of PICC travel . The purpose of this study is to elucidate this association between PICC in upper extremities and LEDVT by observing the changes of D-dimer . Methods: This was a retrospective cohort study of adults in Neurology department who underwent Color Doppler ultrasound and D-dimer test between 1 April 2017 to 1 April 2020. We analyzed the related factors of LEDVT and the change of D-dimer value, compared the changes of D-dimer before and after PICC insertion, and evaluated the predictive value of D-dimer in patients with and without PICC. Results: ① It was found that the presence of PICC increased the risk of lower extremity venous thrombosis by 7 times (OR = 7.048 [95% CI: 4.486-11.074]; ②It was found that the presence of PICC promoted the increase of D-dimer value (OR = 5.133 [95% CI: 3.072-8.575]). ③ For patients without LEDVT, the level of D-dimer in patients with PICC was higher than that in patients without PICC (P < 0.05). ④ The level of D-dimer after PICC insertion was significantly higher than that before PICC insertion(P < 0.05). ⑤ In patients with PICC, the AUC value of D-dimer in the diagnosis of LEDVT was 0.657 (95% CI: 0.549-0.765), and the negative predictive value was 82.35%.Conclusion:PICC insertion may increase the level of D-dimer and become an important risk factor of LEDVT; For patients with PICC , D-dimer value is not suitable to rule out LEDVT.

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“…The signs and symptoms of UEDVT are relatively nonspecific such as swelling, pain, edema, and erythema, regardless of the structure involved [11]. As symptoms are frequently limited to pain and swelling, the diagnosis of DVT can be easily overlooked and can be attributed to the natural course of the muscle injury and surgical repair that occurred.…”

Section: Discussionmentioning

confidence: 99%

Upper-Extremity Deep Venous Thrombosis following a Fracture of the Proximal Humerus: An Orthopaedic Case Report

Strony

Chang

Krieg

2019

Case Reports in Orthopedics

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Deep venous thrombosis of the lower extremities following orthopaedic surgery is well-documented. Though less common than its lower extremity counterpart, upper extremity deep venous thrombosis (UEDVT) has been documented in the literature as well, largely in the context of arthroscopic shoulder surgery. However, there is a paucity of literature documenting UEDVT following surgical fixation of upper extremity fractures, specifically fractures involving the proximal humerus. We present a case of UEDVT following a fracture to the proximal humerus and subsequent surgery. Though UEDVT is considered a rare complication following this type of surgery based on a lack of documentation within the literature, we believe a high-index of suspicion is required to prevent potentially life-threatening sequelae, such as pulmonary embolism (PE) and post-thrombotic syndrome.

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Deep Venous Thrombosis of the Upper and Lower Extremity

Cited by 19 publications

References 28 publications

Overexpressed microRNA‐103a‐3p inhibits acute lower‐extremity deep venous thrombosis via inhibition of CXCL12

Overexpressed microRNA‐103a‐3p inhibits acute lower‐extremity deep venous thrombosis via inhibition of CXCL12

Peripherally Inserted Central Venous Catheter in Upper Extremities Could be a Risk for Deep Vein Thrombosis in Lower Extremities and D-Dimer in Neurology Department

Upper-Extremity Deep Venous Thrombosis following a Fracture of the Proximal Humerus: An Orthopaedic Case Report

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