| Rare thromboses of cerebral, splanchnic and upper-extremity veins. A narrative review. | |
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MedLine Citation:
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PMID: 20352171 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Venous thrombosis typically involves the lower extremity circulation. Rarely, it can occur in the cerebral or splanchnic veins and these are the most frightening manifestations because of their high mortality rate. A third site of rare venous thrombosis is the deep system of the upper extremities that, as for the lower extremity, can be complicated by pulmonary embolism and post-thrombotic syndrome. The authors conducted a narrative review focused on clinical manifestations, risk factors, and treatment of rare venous thromboses. Local risk factors such as infections or cancer are frequent in thrombosis of cerebral or portal veins. Upper extremity deep-vein thrombosis is mostly due to local risk factors (catheter- or effort-related). Common systemic risk factors for rare venous thromboses are inherited thrombophilia and oral contraceptive use; chronic myeloproliferative neoplasms are closely associated with splanchnic vein thrombosis. In the acute phase rare venous thromboses should be treated conventionally with low-molecular-weight heparin. Use of local or systemic fibrinolysis should be considered in the case of clinical deterioration in spite of adequate anticoagulation. Anticoagulation with vitamin K-antagonists is recommended for 3-6 months after a first episode of rare venous thrombosis. Indefinite anticoagulation is recommended for Budd-Chiari syndrome, recurrent thrombosis or unprovoked thrombosis and permanent risk factors. In conclusion, the progresses made in the last couple of decades in diagnostic imaging and the broadened knowledge of thrombophilic abnormalities improved the recognition of rare venous thromboses and the understanding of pathogenic mechanisms. However, the recommendations for treatment mainly derive from observational studies. |
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Authors:
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Ida Martinelli; Valerio De Stefano |
Publication Detail:
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Type: Journal Article Date: 2010-03-29 |
Journal Detail:
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Title: Thrombosis and haemostasis Volume: 103 ISSN: 0340-6245 ISO Abbreviation: Thromb. Haemost. Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-02 Completed Date: 2010-11-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7608063 Medline TA: Thromb Haemost Country: Germany |
Other Details:
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Languages: eng Pagination: 1136-44 Citation Subset: IM |
Affiliation:
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Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, IRCCS Maggiore Hospital, Mangiagalli and Regina Elena Foundation, University of Milan, Milan, Italy. martin@policlinico.mi.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anticoagulants
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pharmacology,
therapeutic use* Cerebral Veins / drug effects Contraceptive Agents / adverse effects Diagnostic Imaging Hematologic Neoplasms / diagnosis, drug therapy, epidemiology, physiopathology Heparin / therapeutic use* Humans Intracranial Thrombosis Regional Blood Flow / drug effects Risk Factors Splanchnic Circulation / drug effects Upper Extremity / blood supply* Venous Thrombosis / diagnosis, drug therapy, epidemiology, physiopathology Vitamin K / antagonists & inhibitors |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Contraceptive Agents; 12001-79-5/Vitamin K; 9005-49-6/Heparin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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