High Prevalence and Mortality Associated with Upper Extremity Deep Venous Thrombosis in Hospitalized Patients at a Tertiary Care Center

Rokosh, Rae S.; Ranganath, Neel K.; Yau, Patricia; Rockman, Caron; Sadek, Mikel; Berland, Todd; Jacobowitz, Glenn R.; Berger, Jeffrey S.; Maldonado, Thomas S.

doi:10.1016/j.avsg.2019.10.055

Cited by 16 publications

(21 citation statements)

References 26 publications

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“…15 UE-DVT can be associated with concurrent PE in 9% to 36% of patients. [9][10][11]18,19 In our study, we excluded patients who had known PE at the time of their UE-DVT diagnosis. The difference in the incidence of PE associated with UE-DVT in the literature is likely due to differences between baseline patient characteristics as well as the frequency of radiologic imaging.…”

Section: Discussionmentioning

confidence: 99%

“…6 Clinicians fear triggering thrombus embolization with CVC removal, and this has not been examined in other studies of UE-DVT. 2,[7][8][9][10][11] A guidance statement from the International Society on Thrombosis and Haemostasis regarding CVC-associated DVT in cancer patients suggests 3 to 5 days of anticoagulation before CVC removal. 12 However, this recommendation is based on expert opinion and not high-quality evidence.…”

Section: Introductionmentioning

confidence: 99%

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Risk of pulmonary emboli after removal of an upper extremity central catheter associated with a deep vein thrombosis

et al. 2021

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Standard treatment of catheter-associated upper extremity deep vein thrombosis (UE-DVT) is anticoagulation, although catheters are often removed for this indication. The optimal time for catheter removal and whether the act and/or timing of catheter removal is associated with pulmonary embolism (PE) remain unknown. A retrospective cohort study was performed at 8 participating institutions through the Venous thromboEmbolism Network US. Patients with hematologic malignancies and central venous catheter (CVC)–associated UE-DVT were included from 1 January 2010 through 31 December 2016. The primary outcome was objectively confirmed PE within 7 days of UE-DVT diagnosis in anticoagulated patients comparing early (≤48 hours) vs delayed (>48 hours) catheter removal. A total of 626 patients were included, among whom 480 were treated with anticoagulation. Among anticoagulated patients, 255 underwent early CVC removal, while 225 had delayed or no CVC removal; 146 patients received no anticoagulation, among whom 116 underwent CVC removal alone. PE within 7 days occurred in 2 patients (0.78%) with early removal compared with 1 patient (0.44%) with delayed or no CVC removal (P > .9). PE or any cause of death within 7 days occurred in 3 patients in both the early removal (1.18%) and delayed/no removal (1.33%) groups (P > .9). In patients treated with CVC removal only (no anticoagulation), there were no PEs but 3 deaths within 7 days. In patients with hematological malignancy and CVC-associated UE-DVT, early removal of CVCs was not associated with an increased risk of PE compared with delayed or no removal.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk of pulmonary emboli after removal of an upper extremity central catheter associated with a deep vein thrombosis

et al. 2021

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“… 15) Studies showed that upper extremity DVT (UEDVT) had a higher prevalence of HF when compared to patients with LEDVT (20% vs. 6.6%). 16) Hospitalized HF patients often undergo central venous puncture and catheterization to receive therapy, most of which are through the upper extremity such as internal jugular vein, and above 10% of them would develop DVT. 17) Also, some patients with undefined cardiomyopathy or who needed pulmonary artery pressure monitoring often undergo right heart catheterization, which may cause right ventricular thrombus 18) and lead to severe PE.…”

Section: Discussionmentioning

confidence: 99%

Heart Failure Is Associated with Increased Risk of Long-Term Venous Thromboembolism

Huang

Liu

et al. 2021

Korean Circ J

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Author's summary The risk of venous thromboembolism (VTE) in out-patients with heart failure (HF) in long-term period is still controversial, resulting in unclear recommendations for long-term treatment. In this analysis, we found that HF was an independent risk for VTE and pulmonary embolism but not deep vein thrombosis in long-term follow-up period. Patients with chronic HF were prone to have higher risk of VTE. This meta-analysis provided an evidence which is supportive for developing strategies for prevention of VTE in patients with HF.

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“…Registro Informatizado de Enfermedad Trombo Embólica (RIETE) enrolled 37366 patients with DVT, among which 35094 (93.9%) cases were LEDVT and the other 2272 (6.1%) were UEDVT [32]. A recent retrospective cohort study of 83 patients hospitalized for DVT showed that 72 cases were LEDVT and 11 cases were UEDVT [33]. Foreign bodies in the vascular system are the most important independent risk factors of DVT [34][35][36].…”

Section: Discussionmentioning

confidence: 99%

Peripherally inserted central venous catheter in upper extremities leads to an increase in D-dimer and deep vein thrombosis in lower extremities

Liu

Zeng

et al. 2021

Preprint

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Background: The purpose of this study is to elucidate the association between peripherally inserted central venous catheter (PICC) in upper extremities and lower extremity deep venous thrombosis (LEDVT) by observing the changes in D-dimer.Methods: This was a retrospective cohort study of 3452 patients (104 inserted with PICCs and 3348 without PICC) enrolled at the neurology department from April 1, 2017 to April 1, 2020. The patients underwent color Doppler ultrasound (CDU) and D-dimer examinations. LEDVT-related factors and the D-dimer value were analyzed before and after PICC insertion. The predictive value of D-dimer for LEDVT was also evaluated. Results: Univariate logistic regression analysis showed that PICC insertion increased the risk of LEDVT by 9 times and promoted the increase of D-dimer by 5 times. After risk adjustment, multivariate logistic regression analysis showed that PICC insertion tripled the risk of LEDVT and doubled the risk of D-dimer increase. The concentration of D-dimer was significantly increased after PICC insertion. D-dimer was unsuitable for excluding venous thrombosis in patients inserted with PICCs.Conclusion: PICC insertion increases the level of D-dimer and the risk of LEDVT. The risks of venous thrombosis need to be assessed in patients inserted with PICCs to ensure the expected clinical outcomes.

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High Prevalence and Mortality Associated with Upper Extremity Deep Venous Thrombosis in Hospitalized Patients at a Tertiary Care Center

Cited by 16 publications

References 26 publications

Risk of pulmonary emboli after removal of an upper extremity central catheter associated with a deep vein thrombosis

Risk of pulmonary emboli after removal of an upper extremity central catheter associated with a deep vein thrombosis

Heart Failure Is Associated with Increased Risk of Long-Term Venous Thromboembolism

Peripherally inserted central venous catheter in upper extremities leads to an increase in D-dimer and deep vein thrombosis in lower extremities

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