Document Detail


Characterizing resolution of catheter-associated upper extremity deep venous thrombosis.
MedLine Citation:
PMID:  19879094     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Catheter-associated upper extremity deep venous thrombosis (CAUEDVT) is well known; however, resolution rates and factors affecting resolution of CAUEDVT are not well characterized. This study determined resolution rates and factors associated with resolution of CAUEDVT.
METHODS: From January 1, 2002, to June 30, 2006, 1761 upper extremity venous duplex ultrasound (DU) studies were performed, and a new UEDVT was found in 253 (14.4%). Of these, 150 patients had routine follow-up and 101 had CAUEDVT. Demographics, follow-up DU results, and risk factors for venous thrombosis were recorded in the patients with follow-up studies and CAUEDVT. Univariate analysis and multivariate logistic regression analysis was performed to determine independent risk factors for complete thrombus resolution.
RESULTS: There were 49 men (49%) and 52 women (51%) with CAUEDVT and follow-up studies. Mean age was 49 years (range, 5 months-80 years). Patients with CAUEDVT had risk factors for venous thrombosis that included malignancy in 34%, recent surgery/trauma in 34%, known hypercoagulable state in 11%, concomitant lower extremity DVT in 21%, and pulmonary embolism in 5%. Complete resolution of DVT on follow-up was documented in 46%. Thrombosis resolved in only 25% (6 of 24) when the catheter was not removed (P <or= .05). Anticoagulation did not improve the rate of thrombus resolution (P <or= 1.0) compared with catheter removal alone. Of the patients who had thrombus resolution, 75% resolved by 100 days (range, 1-914 days) after catheter removal <or=48 hours of diagnosis. In multivariate analysis, only catheter removal predicted the likelihood of thrombus resolution (odds ratio, 3.25; 95% confidence interval, 1.16-9.09; P = .025). New-site UEDVT developed in 86% of patients with CAUEDVT who underwent catheter removal and immediate catheter placement in a new site. Pulmonary embolism developed in five patients with CAUEDVT. Of these, three had documented lower extremity DVT as well. No pulmonary emboli were fatal.
CONCLUSIONS: More than half of CAUEDVT resolve <or=113 days when the catheter is removed <or=48 hours of diagnosis. New-site catheter placement has a high rate of new associated UEDVT. Anticoagulation does not appear to augment resolution of UEDVT.
Authors:
Mark A Jones; Dae Y Lee; Jocelyn A Segall; Gregory J Landry; Timothy K Liem; Erica L Mitchell; Gregory L Moneta
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Publication Detail:
Type:  Journal Article     Date:  2009-10-30
Journal Detail:
Title:  Journal of vascular surgery     Volume:  51     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-01     Completed Date:  2010-02-23     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  108-13     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Utah Vascular Center, Provo, Utah, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Anticoagulants / therapeutic use*
Catheterization, Central Venous / adverse effects*,  instrumentation
Catheters, Indwelling / adverse effects*
Child
Child, Preschool
Device Removal*
Equipment Design
Female
Humans
Infant
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Odds Ratio
Pulmonary Embolism / etiology,  therapy
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Ultrasonography, Doppler, Duplex
Upper Extremity / blood supply*
Upper Extremity Deep Vein Thrombosis / etiology,  therapy*,  ultrasonography
Young Adult
Chemical
Reg. No./Substance:
0/Anticoagulants
Comments/Corrections
Comment In:
J Vasc Surg. 2010 Jan;51(1):113   [PMID:  20117498 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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