Department of Innovative Technologies in Medicine and Dentistry, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy.
Department of Medicine and Ageing Sciences, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy.
Minerva Med. 2021 Dec;112(6):746-754. doi: 10.23736/S0026-4806.21.07578-9. Epub 2021 May 10.
Upper extremity deep vein thrombosis (UEDVT) represents about 5-10% of all cases of deep vein thrombosis (DVT) with a steadily increasing incidence mostly due to the high prevalence of cancer and frequent use of intravascular devices such as central venous catheters and pacemaker. In primary UEDVT, the venous outflow obstruction and subsequent thrombosis are related to congenital or acquired anatomical abnormalities, whereas secondary UEDVT is often associated with malignancy or indwelling lines. A considerable proportion of patients with UEDVT develops serious complications such as recurrent thrombosis, post-thrombotic syndrome, and pulmonary embolism, therefore timely diagnosis and adequate treatment are of crucial importance. Despite sharing many similarities with lower extremity DVT, UEDVT has distinctive features requiring specific diagnostic and therapeutic approaches. The present review discusses the latest evidence on the epidemiology, diagnosis, and treatment of UEDVT, and provides management indications which may help guide clinical decision making.
上肢深静脉血栓形成(UEDVT)占所有深静脉血栓形成(DVT)的 5-10%左右,发病率呈稳步上升趋势,主要与癌症的高发和中心静脉导管和起搏器等血管内装置的频繁使用有关。在原发性 UEDVT 中,静脉流出梗阻和随后的血栓形成与先天性或获得性解剖异常有关,而继发性 UEDVT 常与恶性肿瘤或留置导管有关。相当一部分 UEDVT 患者会出现严重并发症,如复发性血栓形成、血栓后综合征和肺栓塞,因此及时诊断和充分治疗至关重要。尽管与下肢 DVT 有许多相似之处,但 UEDVT 具有独特的特征,需要特定的诊断和治疗方法。本综述讨论了 UEDVT 的最新流行病学、诊断和治疗证据,并提供了可能有助于指导临床决策的管理指征。