The treatment of upper extremities deep vein thrombosis related to thoracic outlet syndrome with direct oral anticoagulants

Fiori, Lorenzo; Serrao, Alessandra; Ferretti, Antonietta; Chistolini, Antonio

doi:10.1177/0268355520967519

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…Thirty-five studies were evaluated as full text, and 20 of these with a total of 1473 patients were included in the analysis (Table 1). 15,21,[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] Study size ranged from 10 to 210 patients. Eleven studies were prospective and nine had a retrospective design.…”

Section: Re Sultsmentioning

confidence: 99%

Anticoagulant treatment for upper extremity deep vein thrombosis: A systematic review and meta‐analysis

Valeriani

Nisio

Porceddu

et al. 2022

Journal of Thrombosis and Haemostasis

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Background Data on anticoagulant treatment for upper extremity deep vein thrombosis (UEDVT) are largely derived from studies on usual site venous thromboembolism (VTE). Objectives The objective of this meta‐analysis was to evaluate the efficacy and safety of anticoagulant therapy for UEDVT. Patients/Methods A systematic search of MEDLINE and EMBASE was conducted for studies including patients with UEDVT. Primary outcomes were recurrent VTE and major bleeding. Secondary outcomes included clinically‐relevant non‐major bleeding and all‐cause mortality. Summary estimates with 95% confidence intervals (CIs) were calculated by random‐effect meta‐analysis. Results A total of 1473 patients from 11 prospective and nine retrospective studies were included. Sixty percent of patients had an indwelling catheter and 56.1% had cancer. Anticoagulant treatment consisted of direct oral anticoagulants, low molecular weight heparin followed by vitamin K antagonists, and low molecular weight heparin alone in 45.1%, 35.0%, and 19.9% of patients, respectively. During a median follow‐up of 13 months, recurrent VTE occurred in 3% of patients (95% CI: 2–4; 21/1334 patients), major bleeding in 3% (95% CI: 2%–5%; 29/1235 patients), clinically‐relevant non‐major bleeding in 4% (95% CI: 3–6; 40/1075 patients), and all‐cause mortality in 9% (95% CI: 5–15; 108/1084 patients). Rates of these outcomes were not significantly different between patients with or without cancer, patients with or without an indwelling catheter, and among those receiving different anticoagulant treatments. Conclusions In patients with UEDVT, anticoagulant treatment is associated with a low risk of recurrent VTE and a nonnegligible risk of major bleeding.

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Section: Re Sultsmentioning

confidence: 99%

Anticoagulant treatment for upper extremity deep vein thrombosis: A systematic review and meta‐analysis

Valeriani

Nisio

Porceddu

et al. 2022

Journal of Thrombosis and Haemostasis

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Posterior nutcracker syndrome: a case report

Gozzo¹,

Farina²,

Foti³

et al. 2021

J Med Case Reports

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Background Posterior nutcracker syndrome is defined by the compression of the left renal vein between the abdominal aorta and a lumbar vertebral body. It can be clinically manifest with intermittent hematuria, gonadal or spermatic reflux resulting in varicocele. Ultrasound is the first-line imaging which require more accurate study with contrast-enhanced computed tomography. Management can be conservative in younger patients with mild hematuria due to the high spontaneous remission rate and invasive with open surgical and endovascular interventions. We describe a very rare case with compression of the left renal vein due to an osteophyte of the spine. Case presentation A 62-year-old Caucasic male came to our radiology department for chronic hepatitis B virus (HBV)-related liver disease follow-up and mild scrotal pain. The ultrasound examination revealed a compression of the left retro-aortic renal vein in the aorto-vertebral space caused by an osteophyte. Duplex Doppler ultrasound revealed flow congestion in the left renal vein and renal failure; power Doppler ultrasound showed left varicocele. Conclusions Doppler ultrasound is the first-line imaging and allows the detection of all the typical signs of posterior nutcracker: left renal vein stenosis, flow congestion and renal failure. Nutcracker syndrome should be suspected in older patients with left varicocele associated with hematuria. Failure to diagnose and treat these patients could have serious consequences for their health.

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The treatment of upper extremities deep vein thrombosis related to thoracic outlet syndrome with direct oral anticoagulants

Cited by 2 publications

References 6 publications

Anticoagulant treatment for upper extremity deep vein thrombosis: A systematic review and meta‐analysis

Anticoagulant treatment for upper extremity deep vein thrombosis: A systematic review and meta‐analysis

Posterior nutcracker syndrome: a case report

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