scholarly journals Primary upper extremity deep vein thrombosis in a Caucasian woman

2019 ◽  
Vol 2 (1) ◽  
pp. 67-72
Author(s):  
Mihaela Ioana Maris ◽  
Mihaela Flavia Avram ◽  
Danina Mirela Muntean
Keyword(s):  
Deep Vein Thrombosis ◽  
Upper Extremity ◽  
Thrombotic Event ◽  
Signs And Symptoms ◽  
Acute Onset ◽  
Lower Limbs ◽  
Caucasian Woman ◽  
Vein Thrombosis ◽  
The Right ◽  
Deep Vein

AbstractCompared to deep vein thrombosis in the lower limbs, upper extremity deep vein thrombosis is uncommon and therefore much less explored or even neglected.We present the case of a 40-year-old female working in the bakery industry, who was admitted for acute onset of upper limb oedema accompanied by pain and functional impairment, affirmative secondary to the sustained and intense effort of the dominant arm. The diagnosis was confirmed by Duplex Ultraso nography on the eighth day after the onset of symptoms. Since clinical examinations and laboratory work excluded any cause of secondary thrombosis, the diagnosis of primary thrombosis was established. The only possible cause of this episode was linked to the woman’s work. The trigger for the thrombotic event was represented most likely by strenuous physical activity with temporary obstruction of the thoracic outlet in the work field. Under anticoagulant treatment, the signs and symptoms gradually resolved. Unfortunately, at the one-year follow-up exam, the patient was diagnosed with post-thrombotic syndrome of the right, dominant arm.

Morbidly Obese Patient on Rivaroxaban Presents With Recurrent Upper Extremity Deep Vein Thrombosis: A Case Report

2019 ◽  
Vol 33 (5) ◽  
pp. 712-719 ◽  
Author(s):  
Sin-Ling T. Jennings ◽  
Khanh N. P. Manh ◽  
Jusilda Bita
Keyword(s):  
Deep Vein Thrombosis ◽  
Obese Patient ◽  
Upper Extremity ◽  
Oral Anticoagulants ◽  
Morbidly Obese ◽  
Vein Thrombosis ◽  
Morbidly Obese Patient ◽  
The Right ◽  
Direct Acting ◽  
Deep Vein

A morbidly obese patient with history of deep vein thrombosis and pulmonary embolism was diagnosed with an acute left upper extremity deep vein thrombosis and started on rivaroxaban. Three months later, the patient returned with swelling in the right arm and was found to have a right brachial thrombosis. Anticoagulant therapy was switched to a low-molecular-weight heparin, and patient was discharged on enoxaparin along with an order to follow-up with a hematologist. Subanalyses from randomized controlled trials, pharmacokinetic/pharmacodynamic, and real-world studies suggest that rivaroxaban may be effective and safe in morbidly obese patients for primary and secondary prevention of venous thromboembolism. However, the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis does not recommend the use of direct-acting oral anticoagulants in this population. If used, drug levels should be monitored to guide the therapy. Due to the disparity in data to show efficacy and safety of rivaroxaban in morbidly obese subjects, the interpatient variability of rivaroxaban’s effects in subjects, and the lack of defined therapeutic range for rivaroxaban drug concentration, rivaroxaban should be used cautiously in this population.

scholarly journals Upper extremity deep vein thrombosis in an informal porter

2020 ◽  
Vol 39 (3) ◽  
pp. 207
Author(s):  
Dewi S. Soemarko ◽  
Herlinah Herlinah
Keyword(s):  
Deep Vein Thrombosis ◽  
Upper Extremity ◽  
Rare Condition ◽  
Predisposing Factor ◽  
Manual Lifting ◽  
Vein Thrombosis ◽  
Medicine Physician ◽  
The Right ◽  
Deep Vein

Background<br />Upper extremity deep vein thrombosis (UEDVT) is a rare condition, in which job-related arm movements and repetitive, forceful or overhead arm activities have been recognized as the predisposing factor for this condition. UEDVT can occur among informal porters. This report describes a case of UEDVT in an informal porter due to manual lifting of heavy goods and reviews the literature for occupational reports of this condition.<br /><br />Case description<br />A 35-year-old male informal porter presented with marked swelling, pain, and numbness of his right arm 3 days after a prolonged episode of lifting heavy goods. A Doppler ultrasound showed thrombosis in the right subclavian and axillary veins and laboratory tests found elevated D-dimer. Patient was diagnosed as having axillo-subclavian thrombosis and treated with low molecular-weight heparin. One month after the last follow-up, patient returned to work with modified capacity and after 3 months of return to work, patient was able to resume his regular duties without impairment or disability.<br /><br />Conclusion<br />The occupation of informal porter should be considered a risk factor for upper extremity deep vein thrombosis (UEDVT), thus the occupational medicine physician should be aware of this condition in the context of manual workers. Detailed occupational history to aid the diagnosis and future risk assessment are needed, and education for preventing UEDVT should be provided to porters.

scholarly journals Nonnegligible causes of symptoms of acute lower extremities——3 cases of May-Thurner syndrome with deep vein thrombosis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yi Sun ◽  
Shenghan Song
Keyword(s):  
Computed Tomography ◽  
Deep Vein Thrombosis ◽  
Iliac Vein ◽  
Lower Limbs ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Left Common Iliac Vein ◽  
Catheter Directed Thrombolysis ◽  
The Right ◽  
Deep Vein

Background May-Thurner syndrome is a kind of disease caused by the compression of the left common iliac vein. It is one of the causes of incomplete venous valves and superficial varicose veins in lower limbs, and is also a potential factor of acute deep vein thrombosis (DVT). Method Here 3 cases are diagnosed as May-Thurner syndrome at different ages. Case presentations 1. A 35-year-old female patient was hospitalized with swelling of the left lower limb for 1 week. Computed tomography (CT) showed compression of the left common iliac vein with thrombosis. May-Thurner syndrome was diagnosed and catheter-directed thrombolysis was performed. 2. A 37-year-old male patient came to our hospital due to sudden swelling of the right lower extremity and pain for 3 days. Computed tomography showed compression of the left common iliac vein and deep venous thrombosis (DVT) of the right iliac vein. May-Thurner syndrome was diagnosed. The patient was performed with inferior vena cava (IVC) filter implantation, catheter-directed thrombolysis and balloon angioplasty for right iliac vein. And the patient recovered well; 3. A 55-year-old female patient came to our hospital with swelling and discomfort in the left lower extremity for 3 days. Computed tomography showed stenosis of the left common iliac vein with deep vein thrombosis. May-Thurner syndrome was diagnosed, balloon dilation and stent implantation were performed. During 3 years of follow-up, there was no swelling or new thrombosis in her lower limbs. Conclusion When encountering unexplained deep vein thrombosis, iliac vein compression syndrome should be considered and treated in time to prevent the recurrence of thrombosis. Catheter-directed thrombolysis can relieve symptoms and stenting placement is the optimal way to relieve stenosis, supplemented by long-term anticoagulation therapy and graduated compression stockings.

scholarly journals Serological Parameters and Vascular Investigation for a Better Assessment in DVT during Pregnancy—A Systematic Review

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 160
Author(s):  
Catalina Filip ◽  
Demetra Gabriela Socolov ◽  
Elena Albu ◽  
Cristiana Filip ◽  
Roxana Serban ◽  
...  
Keyword(s):  
Systematic Review ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Correct Diagnosis ◽  
Thrombotic Event ◽  
Vein Thrombosis ◽  
Major Consequence ◽  
Life Threatening ◽  
The Right ◽  
Deep Vein

Pregnancy and the postpartum period represent a condition characterized by a thrombotic predisposition. The majority of pregnant women do not face acute or severe thrombotic events. In general, mild inconveniences such as leg swelling or moderately painful thrombotic events (phlebitis) are encountered. However, when pregnancy is associated with inherited or acquired deficits that affect homeostasis, the risk of acute or even life-threatening events can increase significantly. The major consequence is the loss of the fetus or the venous thromboembolism that endangers the mother’s life. Venous thromboembolism is caused by deep vein thrombosis, therefore timely detection and especially the assessment of the extent of the thrombotic event are crucial. In this paper we have summarized the most important paraclinical investigations. The study emphasizes the importance of selecting the methods of investigation. The right choice allows establishing a correct diagnosis and individualizing the treatment.

scholarly journals Lower extremities Duplex-Doppler ultrasonography for the detection of suspected deep venous thrombosis: A preliminary report from Sokoto

2016 ◽  
Vol 7 (6) ◽  
pp. 53-57 ◽  
Author(s):  
Shehu B Kakale ◽  
Sadisu M Maaji ◽  
Shamsudden A Aliyu
Keyword(s):  
Deep Vein Thrombosis ◽  
Doppler Ultrasound ◽  
Lower Limb ◽  
Lower Limbs ◽  
Medical Sciences ◽  
Vein Thrombosis ◽  
Duplex Doppler ◽  
The Right ◽  
Deep Vein

Background: There is a paucity of reports on the deep vein thrombosis in our environment.Aims and Objective: The aim of this study is to document the role of Doppler ultrasound in detecting deep vein thrombosis in our environment.Methods and Materials: Between Januarys to December 2014 forty six in patients with suspicion of DVT were evaluated prospectively. All patients presented with symptoms of single or bilateral disease, and a high probability of the disease. Two trained radiologists performed all duplex scan examinations. The patients were scanned using Mindray DC-3/DC-3T Diagnostic ultrasound scanner (Mindray Bio- Medical Electronics Co., LTD) linear (7-12MHz) transducers was used.Results: A total of 46 patients had duplex-Doppler scan examination carried out between January-December 2014. There were 30(65.2%) males and 16(38.8%) females subjects recruited for the study. The mean age was 48.9±SD17.3 with range of 18-85 years. A total of 21 patients (45.6%) were found to have deep vein thrombosis (DVTs) on duplex-Doppler examination. Proximal DVTs was seen in 6(12.9%) and 14(30.3%) for right and left lower limbs respectively. Distal DVTs was seen in 1(2.2%) in the right lower limb and 25(54.4%) show normal findings bilaterally. Diffused DVTs was seen in 2(4.3%) patients involving external, through popliteal veins on the right lower limb. In 3(6.5%) of the patients only the common femoral, superficial femoral and popliteal shows diffuse DVTs.Conclusion: With availability of Doppler ultrasound in our environment the diagnosis of DVT is now easier. Duplex scanning techniques are faster, safer, and less expensive. Because of its noninvasive nature, venous duplex is repeatable, allowing for continued follow up after the diagnosis. Asian Journal of Medical Sciences Vol.7(6) 2016 53-57

D-Dimer Test and Diagnosis of Deep Vein Thrombosis: A Comparative Study of 7 Assays

1996 ◽  
Vol 76 (04) ◽  
pp. 518-522 ◽  
Author(s):  
A Elias ◽  
I Aptel ◽  
B Huc ◽  
J J Chale ◽  
F Nguyen ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Latex Agglutination ◽  
Lower Limbs ◽  
First Episode ◽  
Lower Sensitivity ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
D Dimer

SummaryThe current D-Dimer ELISA methods provide high sensitivity and negative predictive value for the diagnosis of deep vein thrombosis but these methods are not suitable for emergency or for individual determination. We have evaluated the performance of 3 newly available fast D-Dimer assays (Vidas D-Di, BioMerieux; Instant IA D-Di, Stago; Nycocard D-Dimer, Nycomed) in comparison with 3 classic ELISA methods (Stago, Organon, Behring) and a Latex agglutination technique (Stago). One-hundred-and-seventy-one patients suspected of presenting a first episode of deep vein thrombosis were investigated. A deep vein thrombosis was detected in 75 patients (43.8%) by ultrasonic duplex scanning of the lower limbs; in 11 of them the thrombi were distal and very limited in size (<2 cm). We compared the performance of the tests by calculating their sensitivity, specificity, positive and negative predictive value for different cut-off levels and by calculating the area under ROC curves. The concordance of the different methods was evaluated by calculating the kappa coefficient. The performances of the 3 classic ELISA and of the Vidas D-Di were comparable and kappa coefficients indicated a good concordance between the results provided by these assays. Their sensitivity slightly declined for detection of the very small thrombi. Instant IA D-Di had a non-significantly lower sensitivity and negative predictive value than the 4 previous assays; however its performance was excellent for out-patients. As expected, the Latex assay had too low a sensitivity and negative predictive value to be recommended. In our hands, Nycocard D-Dimer also exhibited low sensitivity and negative predictive value, which were significantly improved when the plasma samples were tested by the manufacturer. Thus significant progress has been made, allowing clinical studies to be planned to compare the safety and cost-effectiveness of D-Dimer strategy to those of the conventional methods for the diagnosis of venous thrombosis.

Diagnosis of Deep Vein Thrombosis by Combination of Doppler Ultrasound Flow Examination and Strain Gauge Plethysmography

1982 ◽  
Vol 47 (02) ◽  
pp. 141-144 ◽  
Author(s):  
H Bounameaux ◽  
B Krähenbühl ◽  
S Vukanovic
Keyword(s):  
Deep Vein Thrombosis ◽  
Negative Predictive Value ◽  
Doppler Ultrasound ◽  
Strain Gauge ◽  
Predictive Value ◽  
Lower Limbs ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Strain Gauge Plethysmography ◽  
Deep Vein

SummaryDoppler ultrasound flow examination, strain gauge plethysmography and contrast venography were performed in 160 lower limbs of 80 in-patients. Deep vein thrombosis (DVT) was suspected in 87 limbs. Using measurement of venous stop-flow pressure, the Doppler method had an overall sensitivity of 83%. By combined use of Doppler and Plethysmography, sensitivity was increased to 96%. Specificity was 62% and 51%, respectively. With a positive and a negative predictive value of 80% and 73%, respectively, the combination of both non-invasive methods cannot reliably replace venography in the diagnosis of DTV, although all (40/40) thromboses proximal to or involving the popliteal segment were detected by either Doppler and Plethysmography or both.After exclusion of 14 patients (18%) suffering from conditions known to alter the results of these non-invasive methods, the positive predictive value of abnormal findings in both Doppler and Plethysmography was increased to 94% for suspected limbs, whilst negative predictive value of both negative Doppler and Plethysmography was 90%, allowing the avoidance of venography in these patients.

scholarly journals Recurrence of Upper Extremity Deep Vein Thrombosis Secondary to COVID-19

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 878
Author(s):  
Yesha H. Parekh ◽  
Nicole J. Altomare ◽  
Erin P. McDonnell ◽  
Martin J. Blaser ◽  
Payal D. Parikh
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Upper Extremity ◽  
Thromboembolic Events ◽  
Vein Thrombosis ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Deep Vein

Infection with SARS-CoV-2 leading to COVID-19 induces hyperinflammatory and hypercoagulable states, resulting in arterial and venous thromboembolic events. Deep vein thrombosis (DVT) has been well reported in COVID-19 patients. While most DVTs occur in a lower extremity, involvement of the upper extremity is uncommon. In this report, we describe the first reported patient with an upper extremity DVT recurrence secondary to COVID-19 infection.

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