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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
"treatment is essential to prevent pts in primary uedvt"
symptom
thoracic outlet syndrome
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