Abstract Number: PB2438
Meeting: ISTH 2020 Congress
Theme: Venous Thromboembolism and Cardioembolism » VTE Treatment
Background: Upper extremity (UE) clots result in an incidence of approximately 0.4-1 per 10,000 cases, with no randomized controlled trials on the choice of agent or the duration of anticoagulation, resulting in a wide variability in daily practice.
Aims: 5 year retrospective study of patients with UE DVT to determine practice patterns and management of UE clots.
Methods: All adult patients with suspected UE DVT or superficial vein thrombosis (SVT) presenting to any of the tertiary care centers in the city, who had undergone diagnostic imaging were included in the study, from January 2014 to December 2018. Exclusion criteria included any known cancer. Data collected included basic demographics, duration and choice of anticoagulation, disposition from emergency, workup for thrombophilia and thoracic outlet obstruction (TOO).
Results: 1236 patient records were reviewed, of which 211 were malignancy associated. Of the remaining 1025 patients, 14.7% were positive for UE DVT and 11.1% for SVT. Mean age was 47 years and 50.2% were males. Duration of treatment for both DVT and SVT ranged anywhere from no therapy to lifelong treatment, with an average of 5.01 months for DVT and 1.15 months for SVT (Table 1).
| DVT n=151 (14.7%) | |
| Mean UE DVT treatment duration (months) | 5.01 |
| Lifelong therapy (%) | 34 (22.5) |
| No treatment (%) | 13 (8.6) |
| SVT n=114 (11.1%) | |
| Mean UE SVT treatment duration (months) | 1.15 |
| Treated greater than 45 days (%) | 21 (18.4) |
| Lifelong therapy (%) | 8 (7.0) |
[Table 1. Duration of Treatment in Patients with DVT and SVT]
Anticoagulant agents for DVT included low molecular weight heparin (7.9%), direct oral anticoagulants (39.1%) and warfarin (42.4%) (Figure 1). Followup was quite variable from the emergency department. 30.5% of the patients with DVT were referred to General Internal Medicine (GIM) outpatient, compared to 24.5% to Hematology and 33.7% to their family doctor. 39.7% of the people with DVT were tested for thrombophilia, of which 10% tested positive for any type of thrombophilia. 29.8% were tested for TOO, of which 48.9% were positive and 11.1% received surgery for same.
Conclusions: Our study demonstrates significant variability in the management of UE clots, highlighting the lack of literature in this field and the need for a structured, standardized approach.
[Figure 1]
To cite this abstract in AMA style:
Pannu T, Herget E, Suryanarayan D. Retrospective Study of Patients with Upper Extremity Clots Presenting to Emergency Departments in Tertiary Care Hospitals in a Major Canadian City in the Last Five Years [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/retrospective-study-of-patients-with-upper-extremity-clots-presenting-to-emergency-departments-in-tertiary-care-hospitals-in-a-major-canadian-city-in-the-last-five-years/. Accessed September 27, 2023.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/retrospective-study-of-patients-with-upper-extremity-clots-presenting-to-emergency-departments-in-tertiary-care-hospitals-in-a-major-canadian-city-in-the-last-five-years/