Abstract
BackgroundUpper extremity deep vein thrombosis (UEDVT) constitutes around 10% of all DVT, and can cause both pulmonary embolism (PE) and postthrombotic syndrome (PTS) in the arm. The incidence of secondary UEDVT is increasing due to widespread use of central venous catheters in patients with cancer and other chronic diseases. The safety and efficacy of using new direct acting oral anti coagulants (DOAC) in the treatment of UEDVT has not been systematically evaluated. Our aims were to evaulate efficacy, safety, and risk of recurrence of venous thromboembolism (VTE) during DOAC treatment in UEDVT patients.MethodsData from the Swedish national anticoagulation registry (AuriculA) was retrospectively evaluated for all 55 patients (27 men aged 23–86 years, and 28 women aged 18–75 years) treated with DOAC because of UEDVT between 2012 and 2015 in the southernmost hospital region of Sweden with 1.3 million inhabitants in 2016. Patients were followed for 6 months.ResultsDuring 6 months after institution of DOAC treatment there was one recurrence (2%) of DVT during treatment and two (4%) recurrences after cessation of treatment. No patient died, whereas one (2%) suffered a clinically relevant nonmajor bleeding.ConclusionDOAC can be used in the treatment of UEDVT patients with acceptable efficacy and safety.
Highlights
Upper extremity deep vein thrombosis (UEDVT) constitutes around 10% of all DVT, and can cause both pulmonary embolism (PE) and postthrombotic syndrome (PTS) in the arm
Patients We extracted data from AuriculA [8] for all 55 patients in the southernmost hospital region in Sweden (1.3 million inhabitants) that had been treated with direct acting oral anti coagulants (DOAC) for UEDVT between 2012, when DOAC were first introduced in Sweden, and 2015
The following risk factors for UEDVT were recorded and reviewed in digital medical charts and imaging databases: malignancies diagnosed prior to or at diagnosis of UEDVT, peripheral vein catheter (PVC) inserted
Summary
Upper extremity deep vein thrombosis (UEDVT) constitutes around 10% of all DVT, and can cause both pulmonary embolism (PE) and postthrombotic syndrome (PTS) in the arm. The incidence of secondary UEDVT is increasing due to widespread use of central venous catheters in patients with cancer and other chronic diseases. The safety and efficacy of using new direct acting oral anti coagulants (DOAC) in the treatment of UEDVT has not been systematically evaluated. Our aims were to evaulate efficacy, safety, and risk of recurrence of venous thromboembolism (VTE) during DOAC treatment in UEDVT patients. Whereas DOAC are nowadays considered as first alternative for treatment of PE and DVT in the lower extremities [7], the safety and efficacy of using DOAC for treatment of UEDVT has not been systematically evaluated
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