Management of cancer-associated upper extremity deep vein thrombosis with and without venous catheters at a tertiary care center

© 2018 Introduction: Data on management of upper extremity deep vein thrombosis (UEDVT) in patients with cancer is limited. The objective of this study was to determine risk factors for UEDVT and the rates of recurrence and bleeding in a real-world setting. Methods: Retrospective review of consecuti...

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Main Authors: Said Y. ALKindi, Chatree Chai-Adisaksopha, Matthew Cheah, Lori Ann Linkins
Format: Journal
Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/58907
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spelling th-cmuir.6653943832-589072018-09-05T04:34:57Z Management of cancer-associated upper extremity deep vein thrombosis with and without venous catheters at a tertiary care center Said Y. ALKindi Chatree Chai-Adisaksopha Matthew Cheah Lori Ann Linkins Medicine © 2018 Introduction: Data on management of upper extremity deep vein thrombosis (UEDVT) in patients with cancer is limited. The objective of this study was to determine risk factors for UEDVT and the rates of recurrence and bleeding in a real-world setting. Methods: Retrospective review of consecutive patients assessed for cancer-associated UEDVT. Outcome measures were recurrent venous thromboembolism (VTE), and major and clinically relevant non-major bleeding (CRNMB). Risk factors for recurrent VTE and bleeding were assessed. Results: Mean duration of follow-up was 7.2 months. Two hundred cases were identified; 69% were associated with a central line. Non-line associated UEDVT occurred more frequently in the setting of breast cancer, lung cancer and documented local mass effect. The incidence of recurrent VTE was 18.5%, of which 14 (37.8%) were ipsilateral UEDVT. The risk of recurrence is higher with male gender (HR 2.0, 95% CI; 1.0–4.0). Major and CRNMB occurred in 1% and 11.5%, respectively. Concurrent use of an antiplatelet agent was associated with a higher risk of CRNMB compared to anticoagulant therapy alone (HR 3.9, 95% CI; 1.4–10.7). Conclusions: Presence of a venous catheter was the primary risk factor for UEDVT, however, extrinsic compression by local tumour may be just as important for some cancer types. Furthermore, the majority of recurrent events did not occur in the same upper limb suggesting that UEDVT may be predictive of increased thrombotic risk rather than just a local effect of catheters. 2018-09-05T04:34:57Z 2018-09-05T04:34:57Z 2018-06-01 Journal 18792472 00493848 2-s2.0-85046076949 10.1016/j.thromres.2018.03.020 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85046076949&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/58907
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
spellingShingle Medicine
Said Y. ALKindi
Chatree Chai-Adisaksopha
Matthew Cheah
Lori Ann Linkins
Management of cancer-associated upper extremity deep vein thrombosis with and without venous catheters at a tertiary care center
description © 2018 Introduction: Data on management of upper extremity deep vein thrombosis (UEDVT) in patients with cancer is limited. The objective of this study was to determine risk factors for UEDVT and the rates of recurrence and bleeding in a real-world setting. Methods: Retrospective review of consecutive patients assessed for cancer-associated UEDVT. Outcome measures were recurrent venous thromboembolism (VTE), and major and clinically relevant non-major bleeding (CRNMB). Risk factors for recurrent VTE and bleeding were assessed. Results: Mean duration of follow-up was 7.2 months. Two hundred cases were identified; 69% were associated with a central line. Non-line associated UEDVT occurred more frequently in the setting of breast cancer, lung cancer and documented local mass effect. The incidence of recurrent VTE was 18.5%, of which 14 (37.8%) were ipsilateral UEDVT. The risk of recurrence is higher with male gender (HR 2.0, 95% CI; 1.0–4.0). Major and CRNMB occurred in 1% and 11.5%, respectively. Concurrent use of an antiplatelet agent was associated with a higher risk of CRNMB compared to anticoagulant therapy alone (HR 3.9, 95% CI; 1.4–10.7). Conclusions: Presence of a venous catheter was the primary risk factor for UEDVT, however, extrinsic compression by local tumour may be just as important for some cancer types. Furthermore, the majority of recurrent events did not occur in the same upper limb suggesting that UEDVT may be predictive of increased thrombotic risk rather than just a local effect of catheters.
format Journal
author Said Y. ALKindi
Chatree Chai-Adisaksopha
Matthew Cheah
Lori Ann Linkins
author_facet Said Y. ALKindi
Chatree Chai-Adisaksopha
Matthew Cheah
Lori Ann Linkins
author_sort Said Y. ALKindi
title Management of cancer-associated upper extremity deep vein thrombosis with and without venous catheters at a tertiary care center
title_short Management of cancer-associated upper extremity deep vein thrombosis with and without venous catheters at a tertiary care center
title_full Management of cancer-associated upper extremity deep vein thrombosis with and without venous catheters at a tertiary care center
title_fullStr Management of cancer-associated upper extremity deep vein thrombosis with and without venous catheters at a tertiary care center
title_full_unstemmed Management of cancer-associated upper extremity deep vein thrombosis with and without venous catheters at a tertiary care center
title_sort management of cancer-associated upper extremity deep vein thrombosis with and without venous catheters at a tertiary care center
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85046076949&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/58907
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