PTS is a frequent complication of UEDVT, yet little is known regarding risk factors and optimal management. A standardized means of diagnosis would help to establish better management protocols. The impact of upper extremity PTS on quality of life should be further quantified.
Seven studies were reviewed. The frequency of PTS after UEDVT ranges from 7- 46% (weighted mean 15%). Residual thrombosis and Axillo-Subclavian vein thrombosis appear to be associated with an increased risk of PTS, whereas catheter-associated UEDVT may be associated with a decreased risk. There is currently no validated, standardized scale to assess upper extremity PTS, and little consensus regarding the optimal management of this condition. Quality of life is impaired in patients with upper extremity PTS, especially after DVT of the dominant arm.
In our clinical practice, we generally recommend heparin therapy for the upper limb DVT, which is less expensive and easy to administer. We do not have cost benefit evaluation studies comparing the thrombolytic and heparin therapies for upper limb DVT. It is possible to expect the results of thrombolysis in the Upper limb DVT, similar to lower limb DVT. It is also common to see the upper limb DVT in the patients who are on IJV or subclavian catheter for the hemodialysis. In our hospital this aspect of the DVT in the upper limb can be studied further to understand the significance of the PTS in the upper limb DVT associated with central venous catheters.
References:
Seven studies were reviewed. The frequency of PTS after UEDVT ranges from 7- 46% (weighted mean 15%). Residual thrombosis and Axillo-Subclavian vein thrombosis appear to be associated with an increased risk of PTS, whereas catheter-associated UEDVT may be associated with a decreased risk. There is currently no validated, standardized scale to assess upper extremity PTS, and little consensus regarding the optimal management of this condition. Quality of life is impaired in patients with upper extremity PTS, especially after DVT of the dominant arm.
In our clinical practice, we generally recommend heparin therapy for the upper limb DVT, which is less expensive and easy to administer. We do not have cost benefit evaluation studies comparing the thrombolytic and heparin therapies for upper limb DVT. It is possible to expect the results of thrombolysis in the Upper limb DVT, similar to lower limb DVT. It is also common to see the upper limb DVT in the patients who are on IJV or subclavian catheter for the hemodialysis. In our hospital this aspect of the DVT in the upper limb can be studied further to understand the significance of the PTS in the upper limb DVT associated with central venous catheters.
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