Upper Extremity Deep Vein Thrombosis

Upper extremity deep vein thrombosis (UEDVT) accounts for up to 10% of all deep vein thrombosis. The incidence is increasing, which is mostly due to extensive use of central venous catheters (CVCs). UEDVT often presents with unilateral swelling and pain but may be asymptomatic. Several factors increase the risk of UEDVT, of which cancer and CVCs are the strongest risk factors. To prevent acute complications and long-term sequelae of UEDVT, such as pulmonary embolism and the post-thrombotic syndrome, a prompt diagnosis and effective and safe therapy are crucial. Objective imaging through venography or compression ultrasonography is at present the cornerstone of diagnosis, despite its moderate efficiency. Current treatment options for UEDVT are anticoagulant therapy, thrombolytic therapy, mechanical catheter interventions, first rib resection in case of thoracic outlet syndrome, and vena cava filter placement. Routine thromboprophylaxis in patients with a CVC is currently not recommended.