RESUMEN
We aimed to evaluate patients with upper extremity deep vein thrombosis (UEDVT) in terms of the risk factors, symptoms, clinical course, diagnostic approaches and treatment outcome. Thirty-six patients with a diagnosis of UEDVT, comprising 19 males (52.7%) and 17 females (47.3%), were included in the study; the mean (+/- SD) age was 54 +/- 12.3 years. The most common risk factor was central venous catheter use. The treatment protocol consisted of low molecular weight heparin for up to 7 days, followed by oral anticoagulants for up to 6 months. All patients were followed up for 1 year. More than 90% of the patients responded well to treatment. Nine patients (25%) died due to underlying diseases; no patients died secondary to UEDVT. None of the patients developed pulmonary embolus or recurrent deep venous thrombosis, and post-thrombotic syndrome was not observed. The mortality rate was related to the underlying diseases.
Asunto(s)
Trombosis de la Vena/diagnóstico , Trombosis de la Vena/terapia , Adulto , Anciano , Anticoagulantes/administración & dosificación , Cateterismo Venoso Central , Femenino , Heparina/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/complicaciones , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Ultrasonografía , Extremidad Superior/patologíaRESUMEN
The creation of an arteriovenous fistula (AVF) is frequently used to achieve easier access for haemodialysis in patients with chronic renal insufficiency. The most frequent late complication of AVFs is aneurysm formation, which carries the risk of spontaneous rupture. This study reports on 18 patients with giant aneurysms that developed on antebrachial AVFs who were operated on over a period of 6 years. Colour duplex ultrasonographic examination of the upper extremity was performed in all but one patient in the preoperative period. Surgical management included resection of the aneurysm and re-establishment of arterial continuity. There were no complications such as infection, ischaemic extremity loss, neurological sequelae or mortality. Colour duplex ultrasonographic examinations after 6 months were all normal. The mean follow-up period was 29.1 months (range 7-50 months). There were no additional vascular complications observed during follow-up. Early surgical intervention is the recommended treatment of choice for giant aneurysm complicating antebrachial AVF.