Abstract Number: PB2260
Meeting: ISTH 2020 Congress
Background: Dynamic upper limb ultrasound (DULUS) is often undertaken in the investigation of thoracic outlet syndrome (TOS) to assess compression of thoracic outlet structures, such as the subclavian vein (SCV) in venous TOS (VTOS), subclavian artery (SCA) in arterial TOS and brachial plexus in neurogenic TOS. DULUS measures peak systolic velocities (PSV) in the subclavian artery (SCA) at various degrees of abduction as well as assessing SCV compression. However, there is no data on expected values in subjects with antecedent idiopathic upper extremity deep vein thrombosis (IUEDVT).
Aims: To describe DULUS findings in upper limbs with and without antecedent IUEDVT.
Methods: We reviewed all DULUS performed between January 2014 and May 2019 at Monash Health, Melbourne. At our institution, SCA PSV at neutral, 45°, 90° and 130° abduction, military brace (MB) and reverse stop (RS) positions are recorded. We expressed the PSV obtained at these positions over neutral as the PSV ratio (Figure 1). Other measures included assessment for SCV compression at 90° abduction.
Results: DULUS on 27 upper limbs were included (9 males, mean age 37 years [range 26-54]). Nine sides had antecedent IUEDVT and 18 had not. Age and gender were not different between the two groups. 10 patients had right-sided symptoms. We found SCA PSV ratios at 90° and 130° abduction were higher in the IUEDVT-affected sides compared to non-IUEDVT affected sides (Figure 2). Nearly all cases demonstrated some degree of SCV compression at 90° abduction.
Conclusions: On DULUS, upper limbs with antecedent IUEDVT had higher SCA PSV ratios at 90° and 130° abduction than non-IUEDVT sides but compression of the SCV was commonly observed at 90°in both groups. The clinical significance of these observations is uncertain; whether these findings correlate with subsequent or prior IUEDVT requires further study.
To cite this abstract in AMA style:Yuen HLA, Chunilal S. Dynamic Upper Limb Ultrasound in Idiopathic Upper Extremity Deep Vein Thrombosis [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/dynamic-upper-limb-ultrasound-in-idiopathic-upper-extremity-deep-vein-thrombosis/. Accessed January 28, 2022.
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