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Deep venous thrombosis of the upper extremity. A review.
[thoracic outlet syndrome]
Upper
extremity
deep
venous
thrombosis
(
UEDVT
)
occurs
either
spontaneously
,
as
a
consequence
of
strenuous
upper
limb
activity
(
also
known
as
the
Paget
-
Schroetter
syndrome
)
or
secondary
to
an
underlying
cause
.
Primary
and
secondary
UEDVT
differs
in
long
-term
sequelae
and
mortality
.
This
review
will
focus
on
the
clinical
presentation
,
risk
factors
,
diagnosis
,
and
treatment
strategies
of
UEDVT
.
In
the
period
from
January
to
October
2012
an
electronic
literature
search
was
performed
in
the
PubMed
/
MEDLINE
database
,
and
27
publications
were
included
.
swelling
,
pain
and
functional
impairment
are
typical
symptoms
of
UEDVT
,
although
completely
asymptomatic
cases
have
been
described
.
However
life-threatening
,
massive
pulmonary
embolism
(
PE
)
can
also
be
a
sign
of
UEDVT
.
for
the
primary
condition
anatomical
abnormalities
(
Thoracic
Outlet
Syndrome
,
TOS
)
may
dispose
to
the
condition
.
Malignancy
and
therapeutic
interventions
are
major
risk
factors
for
the
secondary
deep
vein
thrombosis
in
combination
with
the
patient
's
characteristics
,
comorbidities
and
prior
history
of
deep
vein
thrombosis
.
recurrent
deep
venous
thrombosis
,
pulmonary
embolism
and
Post
Thrombotic
Syndrome
(
PTS
)
are
the
major
complications
after
UEDVT
.
PTS
is
a
chronic
condition
leading
to
significant
functional
disability
and
impaired
quality
of
life
.
compression
ultrasonography
is
noninvasive
and
the
most
frequently
used
objective
test
with
a
high
accuracy
in
experienced
hands
.
Treatment
modalities
and
strategies
:
the
treatment
modalities
include
anticoagulation
therapy
,
catheter-directed
thrombolysis
,
surgical
decompression
,
percutaneous
transluminal
angioplasty
and
stenting
and
they
may
be
combined
.
However
,
the
optimal
treatment
and
timing
of
treatment
remains
controversial
.
Early
diagnosis
and
treatment
is
essential
to
prevent
PTS
in
primary
UEDVT
;
however
,
there
is
no
consensus
on
which
treatment
is
the
best
.
Anticoagulation
is
still
considered
the
treatment
of
choice
for
at
least
3
-
6
months
,
until
Randomized
Controlled
Trials
may
have
demonstrated
otherwise
.
Diseases
Validation
Diseases presenting
"pain"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
aniridia
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital diaphragmatic hernia
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
cystinuria
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
focal myositis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
malignant atrophic papulosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
pleomorphic liposarcoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
scrub typhus
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
trochlear dysplasia
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
wolf-hirschhorn syndrome
This symptom has already been validated