Endovascular management of acute upper extremity deep venous thrombosis and the use of superior vena cava filters.

ABSTRACT

Upper extremity deep venous thrombosis (UEDVT), though less common than lower extremity DVT, is a significant problem with several possible etiologies. The incidence of UEDVT is on the rise, primarily from the increasing use of central venous access devices. However, there are other causes of UEDVT, including primary venous thrombosis (Paget-Schroetter syndrome) and hypercoagulable states associated with underlying malignancy. The morbidity and mortality associated with UEDVT is largely from pulmonary embolism and the postphlebitic syndrome. Nevertheless, many UEDVTs are asymptomatic or patients may present with nonspecific clinical symptoms; therefore, a high index of suspicion is often necessary to make a correct diagnosis. Currently, there is no standard treatment algorithm for UEDVT. Treatment options may range from systemic anticoagulation to surgical correction depending on the etiology of the thrombus, as well as the patient's associated comorbidities, life expectancy and expected quality of life following treatment.