Risk Factors for Deep Venous Thrombosis of the Upper Extremities

Martinelli, Ida; Cattaneo, Marco; Panzeri, Daniela; Taioli, Emanuela; Mannucci, Pier Mannuccio

doi:10.7326/0003-4819-126-9-199705010-00006

Cited by 109 publications

(72 citation statements)

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“…In the first case-control study with a total of 36 patients with DVTUE, Martinelli et al found a prevalence of abnormalities in the coagulation system of only 8% [6]. This was comparable with a control group of individuals without thrombosis.…”

Section: Discussionmentioning

confidence: 86%

“…The role of these low-titer antibodies in the pathogenesis of venous thrombosis is still a matter of debate [10]. The prevalence of APA is strongly dependent upon the methods used, which were not properly described in some of the previous studies [6,11]. Also the time point of testing for antibodies is important, because APA may be transient and therefore missed if the moment of blood sampling is long after the thrombotic event.…”

Section: Discussionmentioning

confidence: 99%

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Hypercoagulability states in upper‐extremity deep venous thrombosis

et al. 2001

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Deep venous thrombosis of the upper extremity (DVTUE) is a rare thrombotic disorder that may occur spontaneously but is most often related to predisposing factors, such as an indwelling central venous catheter, malignancy, or exercise. The role of coagulation disorders, i.e., a hypercoagulable state in the pathogenesis of DVTUE is not well known. We have evaluated both genetic and acquired thrombophilia parameters in consecutive patients with DVTUE. A hypercoagulable state was found in 32% of the patients. The most frequent coagulation abnormality was the presence of lupus anticoagulant or anticardiolipin antibodies (27%). Factor V Leiden mutation was detected in two patients, antithrombin deficiency in one, and none of the patients had the prothrombin G20210A gene variant or protein C or S deficiency. The prevalence of coagulation abnormalities was not significantly different in a subgroup of patients with spontaneous DVTUE as compared to those with an obvious predisposing factor, such as an indwelling central venous catheter. We conclude that antiphospholipid antibodies are frequently found in patients with DVTUE. Factor V Leiden mutation, prothrombin 20210A gene variant, protein C deficiency, and protein S deficiency do not seem to play a major pathogenetic role in DVTUE. Am. J. Hematol. 67:15-19, 2001.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Hypercoagulability states in upper‐extremity deep venous thrombosis

et al. 2001

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“…Ruggeri et al [20] reported a congenital coagulation defect in only two out of 27 patients (7.4%) with upper-limb thrombosis and positive anticardiolipin antibodies in 4 cases (14.8%). Martinelli et al [5] found an inherited hypercoagulable status in only three out of 36 patients (8%) with spontaneous UEDVT. This prevalence was similar to a control healthy group but significantly lower than a cohort of patients with lower-limb DVT (56%).…”

Section: Discussionmentioning

confidence: 95%

“…Several studies reported an increased evidence that hyperhomocysteinemia is a risk factor for venous thrombosis and that the association of this coagulation abnormality with other genetic or acquired thrombophilic defects further increased this risk. Reviewing the series published about prevalence of thrombophilic states in UEDVT, only the one by Martinelli et al [5] evaluated plasma homocysteine levels and found hyperhomocysteinemia in 6% of patients with UEDVT and in 14% with lower extremities DVT. In our series, we found high plasma homocysteine levels in five patients (16%) with a combined diagnosis of hyperhomocysteinemia and lupus anticoagulant in two of them.…”

Section: Discussionmentioning

confidence: 99%

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Primary upper‐extremity deep vein thrombosis: High prevalence of thrombophilic defects

et al. 2004

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Primary deep venous thrombosis of the upper extremity (UEDVT) is an unusual disorder. Limited data are available on the contribution of hypercoagulable status in the pathogenesis of this disease. This study aims to report the prevalence of inherited and acquired thrombophilic risk factors (TF) in patients with primary (effort-related and spontaneous) UEDVT. From 1993 to 2002, 31 patients (17 females, median age 38.8 years, range 16-60 years; and 14 males, median age 31.4 years, range 20-56 years) with primary UEDVT (n = 15 effort-related and n = 16 spontaneous) were referred for screening of hypercoagulable status. Nineteen (61.3%) patients had at least one coagulation abnormality. The most common acquired TF were antiphospholipid antibodies (31% lupus anticoagulant and 12.9% anticardiolipin antibodies). Factor V Leiden (12.9%) and prothrombin G20210A mutation (20%) were the most prevalent genetic risk factors. Five patients (16.1%) had high plasma homocysteine levels, and one patient (4.7%) had protein S deficiency. Effortrelated UEDVT was associated with male gender (P = 0.04) and younger age (P = 0.02). There was no significant difference in the prevalence of acquired or inherited TF between patients with effort-related or spontaneous UEDVT. A local anatomic abnormality was detected in seven patients (22.5%), and the prevalence of TF was significantly lower within this group (P = 0.006). The incidence of TF in patients without an anatomic abnormality was 75% (RR 5.25). This study found a high prevalence of an underlying thrombophilic status in spontaneous and effort-related UEDVT. Hypercoagulable status may play a significant role in both groups. Screening for local anatomical abnormalities and thrombophilia should be included in the evaluation of primary UEDVT. Am.

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