• direct oral anticoagulants
• randomized clinical trials
• review
• unusual-site thrombosis
• venous thrombosis

• Anticoagulation therapy
• Deep vein thrombosis
• Lower extremity DVT
• Neurocritical care
• Pulmonary embolism
• Upper extremity DVT
• Venous thromboembolism

• Humans
• Pulmonary Embolism
• Male
• Female
• Middle Aged
• Retrospective Studies
• Venous Thrombosis/epidemiology
• Lower Extremity/blood supply
• Aged
• Critical Care
• Upper Extremity/blood supply
• Adult
• Anticoagulants/therapeutic use
• Intensive Care Units
• Risk Factors

• Paget–Schroetter syndrome
• bleeding
• deep vein thrombosis
• lower extremity
• recurrence
• upper extremity

• Central catheter
• Hospitalized patients
• PICC line
• Upper extremity vein thrombosis

• Female
• Humans
• Catheterization, Central Venous/adverse effects
• Upper Extremity Deep Vein Thrombosis/epidemiology
• Upper Extremity Deep Vein Thrombosis/etiology
• Upper Extremity Deep Vein Thrombosis/therapy
• Retrospective Studies
• Venous Thrombosis/etiology
• Risk Factors
• Upper Extremity

• crohn’s disease (cd)
• deep vein thrombosis (dvt)
• hemato oncology
• peripherally inserted central catheter (picc)
• upper limb thrombosis

• Clinical outcomes
• clinical profile
• risk factors
• venous thromboembolism

• Humans
• Venous Thromboembolism/epidemiology
• Venous Thromboembolism/diagnosis
• Venous Thromboembolism/prevention & control
• Anticoagulants/therapeutic use
• Tertiary Care Centers
• Venous Thrombosis/epidemiology
• Pulmonary Embolism/epidemiology
• Pulmonary Embolism/therapy
• Pulmonary Embolism/diagnosis
• Risk Factors

• central venous catheter
• malignant tumor
• mortality
• pulmonary embolism
• upper extremity deep vein thrombosis

Upper extremity deep vein thrombosis (UEDVT) is less common than lower extremity DVT but is a cause of significant morbidity and mortality in intensive care unit patients. Increasing cancer incidence, prolonged life expectancy and increasing use of intravascular catheters and devices has led to an increased incidence of UEDVT. It is also associated with high rates of complications like pulmonary embolism, post-thrombotic syndrome and recurrent thrombosis. Clinical prediction scores and D-dimer may not be as useful in identifying UEDVT; hence, a high suspicion index is required for diagnosis. Doppler ultrasound is commonly employed for diagnosis, but other tests like computed tomography and magnetic resonance imaging venography may also be required in some patients. Contrast venography is rarely used in patients with clinical and ultrasound findings discrepancies. Anticoagulant therapy alone is sufficient in most patients, and thrombolysis and surgical decompression is seldom indicated. The outcome depends on the cause and underlying comorbidities.

• Catheter associated deep vein thrombosis
• Pacemaker associated deep vein thrombosis
• Paget-von Schröetter syndrome
• Thoracic outlet syndrome
• Upper extremity deep vein thrombosis

• central venous catheter (cvc)
• orthopedics and traumatology
• pulmonary embolism
• thromboprophylaxis
• upper-extremity fracture
• upper-extremity trauma
• venous thromboembolism (vte)

• Compression ultrasound
• Thrombosis
• diagnostic criteria
• differential diagnosis
• pitfalls

• Humans
• Ultrasonography
• Thrombosis/diagnostic imaging

• Cancer-associated thrombosis
• Catheter-related thrombosis
• Central venous access devices
• Peripherally inserted catheter

• Armschwellung
• Armthrombose
• Humeral fracture
• Humerusfraktur
• Lymphödem
• arm swelling
• arm thrombosis
• lymphedema

• Aged
• Arm
• Edema/etiology
• Hand
• Humans
• Humeral Fractures
• Thrombosis
• Venous Thrombosis/diagnosis
• Venous Thrombosis/drug therapy

Temporary pacing is usually performed by cardiologists under fluoroscopic, echocardiographic, or ECG guidance. However, in the developing world, there are inadequate number of cardiologists, and C-arm, catheterization laboratories, or echocardiography are not available at primary or secondary healthcare facilities. In addition, in emergencies option of fluoroscopy and echocardiography is limited. So these patients are transferred to a facility where cardiologists and these facilities are available. Crucial time is lost in transit, which leads to increased mortality. In this study, we aimed to evaluate the safety, efficacy, and practicability of unguided temporary pacemaker insertion.

A total of 1093 patients were enrolled in this study. After cannulating the internal jugular vein or subclavian vein, the pacing lead attached to the pulse generator was advanced blindly till ventricular pacing was achieved. Procedural success was taken as the primary endpoint. Secondary endpoints included the number of attempts taken for successful central venous puncture and procedural time. Complications and mortality were assessed for safety outcomes. Finally, the position of the pacing lead was assessed after the procedure on X-ray or fluoroscopy. The procedure was successful in all but one patient in whom a femoral vein approach was required because of brachiocephalic vein obstruction. Right internal jugular access was achieved in 981 (89.75%) patients. The mean number of attempts taken for achieving successful venous accesses was 1.54 ± 0.85; however, in 726 (66.42%) patients it was achieved in the first attempt. The mean procedural time was 11.5 ± 2.1 min. Overall, 117 (10.70%) patients developed complications; however, most of them were minor. Pneumothorax developed in 12 (1.1%) patients, of whom 2 needed an intercostal tube. Pericardial effusion was seen in 21 (1.92%) patients. Pacing lead tip was located in the right ventricular cavity abutting interventricular septum or free wall in 843 (77.20%) patients. No mortality attributable to procedure occurred.

Unguided temporary pacing via jugular or subclavian venous approach in an emergency setting is possible with high success and a low complication rate. Thus, it is a safe and effective procedure, and clinicians working at primary and secondary healthcare levels should be encouraged to perform this procedure.

Trial registration UMIN Clinical Trials Registry, UMIN000046771. Registered 28 January 2022—Retrospectively registered, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000053348

• Bradycardia
• Heart block
• Internal jugular vein
• Myocardial infarction
• Temporary pacing

• muscle disease
• musculoskeletal and joint disorders
• musculoskeletal syndromes
• vascular surgery

• Arm
• Humans
• Male
• Muscle, Skeletal
• Reproducibility of Results
• Retrospective Studies
• Rhabdomyolysis/diagnosis
• Rhabdomyolysis/therapy
• Upper Extremity Deep Vein Thrombosis/diagnosis
• Upper Extremity Deep Vein Thrombosis/surgery

• cardiac implantable electronic devices
• endocardium
• infection
• venography
• venous occlusion
• venous patency

• Defibrillators, Implantable/adverse effects
• Electronics
• Humans
• Reoperation/methods
• Retrospective Studies
• Vascular Diseases/etiology

• Autopsy
• Excipients/adverse effects
• Fatal Outcome
• Humans
• Lung
• Lung Diseases
• Tablets/adverse effects

• Dialysis
• Hemodialysis
• Medical students
• PoCUS
• Training
• Ultrasonography
• Ultrasound
• Venous thrombosis

• Effort thrombosis
• First rib resection
• Paget-Schroetter syndrome
• Scalenectomy
• Subclavian thrombosis
• TOS
• Venous thoracic outlet syndrome
• vTOS

Venous thromboembolism is a common cause of morbidity and mortality in hospital patients, especially that of the lower extremities. Risk factors and diagnostic elements of upper-extremity deep-vein thrombosis (UEDVT) are poorly understood compared to those of the lower extremities. The primary objectives of this study were to identify predictive risk factors of secondary UEDVT.

This retrospective study included all nonpregnant patients aged >18 years who had undergone upper-extremity duplex scans to check for the presence of secondary UEDVT at Richmond University Medical Center from January 2014 to March 2020. Patients were stratified by presence or absence of UEDVT. Collected data points included patient demographics, comorbidities, central-line use, platelet count at time of scan, length of stay, and overall mortality. IBM 27.0 was used for all statistical analysis, with p<0.05 considered significant.

A total of 1,009 upper extremity venous duplex studies were included. There were no significant differences in age, sex, race, or mean platelet levels between patients diagnosed with DVT and those without (p<0.05). After multinomial regression analysis, central venous catheter (CVC; 26.8% versus 78.5%, aOR 1.770, 95% CI 1.150–2.725; p<0.002), peripherally inserted central catheter (PICC) line (17.5% versus 82.5%, aOR3.254, 95% CI 1.997–5.304; p<0.001), hypertension (67.8% versus 28.8%, aOR 1.641, 95% CI 1.136–2.369; p<0.001), chronic kidney disease (CKD; 34.5% versus 65.5%, aOR 1.743, 95% CI 1.201–2.531; p<0.001), and malignancy (27.1% versus 74.6%, aOR 1.475, 95% CI 0.994–2.190; p<0.053) were found to be independent predictors of UEDVT.

Use of CVC or PICC line, preexisting diagnosis of hypertension, malignancy, and CKD were independent risk factors of UEDVT, while there was no significant correlation between increased platelet levels and UEDVT.

• deep-vein thrombosis
• risk factors
• thrombocytosis
• thromboembolism
• upper extremity

• Upper extremity deep vein thrombosis
• paget schroetter syndrome
• postthrombotic syndrome
• primary
• secondary
• therapeutic
• thrombolysis
• upper extremity deep vein thrombosis

The cumulative incidence, risk factors, rate of subsequent venous thromboembolism (VTE) and bleeding and impact on mortality of isolated upper extremity deep vein thrombosis (UE DVT) in acute leukemia are not well-described. The California Cancer Registry, used to identify treated patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) diagnosed between 2009 and 2014, was linked with the statewide hospitalization database to determine cumulative incidences of UE DVT and subsequent VTE and bleeding after UE DVT diagnosis. Cox proportional hazards regression models were used to assess the association of UE DVT on the risk of subsequent pulmonary embolism (PE) or lower extremity deep vein thrombosis (LE DVT) and subsequent bleeding, and the impact of UE DVT on mortality. There were 5,072 patients identified: 3,252 had AML and 1,820 had ALL. Three- and 12-month cumulative incidences of UE DVT were 4.8% (95% confidence interval [CI]: 4.1–5.6) and 6.6% (95% CI: 5.8–7.5) for AML and 4.1% (95% CI: 3.2–5.1) and 5.9% (95% CI: 4.9–7.1) for ALL, respectively. Twelve-month cumulative incidences of subsequent VTE after an incident UE DVT diagnosis were 5.3% for AML and 12.2% for ALL. Twelve-month cumulative incidences of subsequent bleeding after an incident UE DVT diagnosis were 15.4% for AML and 21.1% for ALL. UE DVT was associated with an increased risk of subsequent bleeding for both AML (hazard ratio [HR]: 2.07; 95% CI: 1.60–2.68) and ALL (HR: 1.62; 95% CI: 1.02–2.57) but was not an independent risk factor for subsequent PE or LE DVT for either leukemia subtype. Isolated incident UE DVT was associated with increased leukemia-specific mortality for AML (HR: 1.42; 95% CI: 1.16–1.73) and ALL (HR: 1.80; 95% CI: 1.31–2.47). UE DVT is a relatively common complication among patients with AML and ALL and has a significant impact on bleeding and mortality. Further research is needed to determine appropriate therapy for this high-risk population.

• acute leukemia
• deep vein thrombosis
• upper extremity deep vein thrombosis
• venous thromboembolism

Upper extremity deep vein thrombosis (UEDVT) accounts for 5% of all deep vein thromboses (DVTs). UEDVT may be complicated by post thrombotic syndrome and pulmonary embolism, and early recognition and prompt start of anticoagulant treatment are key. Primary UEDVT, also known as Paget-von Schrötter syndrome, is associated with repeated or sudden physical activity of the upper arm and venous outflow obstruction due to anatomical variations. Secondary UEDVT is often associated with malignancy or use of intravenous devices, such as central venous catheters or pacemaker leads. Although the diagnosis and treatment of UEDVT have many similarities with DVT of the lower extremities, knowledge of specific aspects regarding UEDVT is important to guide optimal management. In this review, we will discuss the epidemiology, diagnosis, and treatment of UEDVT based on the current literature.

• diagnosis
• epidemiology
• treatment
• upper extremity deep vein thrombosis

• Cirugía ortopédica mayor
• Columna
• Extremidad inferior
• Extremidad superior
• Lower limb
• Major orthopaedic surgery
• Profilaxis tromboembólica
• Spin
• Thromboembolism prophylaxis
• Upper limb

• Anticoagulation
• Treatment
• Upper extremity deep vein thrombosis

• Deep vein thrombosis
• Neurosurgery
• Pulmonary embolism
• Ultrasonography
• Venous thromboembolism

• Cancer
• Catheter-related thrombosis
• Thrombosis

Paradoxical embolism occurs when thrombotic material traverses a right-to-left shunt. We describe the first case of paradoxical stroke resulting from manipulation of a disused chemotherapy port. Contrast studies revealed that the mechanism was systemic-to-pulmonary venous shunt, in which systemic veins drain into the left atrium via collaterals. Chronically thrombosed central venous catheters may result in venous stenosis and shunt formation, exposing patients to risks of paradoxical stroke, acute coronary syndrome, hypoxemia, and other complications. This case highlights the life-threatening complications that may result from neglect of an implantable central venous catheter. Preventative measures are to promptly recognize and treat catheter-related thrombosis and to remove unneeded catheters.

• central venous access device
• paradoxical embolism
• paradoxical stroke
• right-to-left shunt
• systemic-to-pulmonary venous shunt

Patients with cancer have an increased risk of venous thromboembolism. Upper extremity venous system is a peculiar site, and little is known about the clinical course in patients with cancer. Electronic medical records were searched for patients with cancer with a diagnosis of upper extremity venous thrombosis. Individual patient data were reviewed. Eighty-seven patients were identified, and the median age was 52.4. The most common underlying malignancies were breast (23.0%), colorectal (18.4%), and gastroesophageal (18.4%). Median time from cancer diagnosis to upper extremity venous thromboembolism (UEDVT) was 3.44 months. Subclavian vein was the most common involved site (56.3%) and 54.0% patients had a central venous catheter; 50.6% of patients developed a complication; pulmonary embolism (PE) in 9.2%, superior vena cava (SVC) syndrome in 14.9%, and 26.4% had postthrombotic syndrome. In patients with isolated single vein thrombosis, complications were higher in the subset with internal jugular vein involvement compared to other sites (68.2% vs 52.2%) as were complications in patients with non-catheter-related thrombosis compared to patients with a central venous catheter in place (55% vs 27.7%). Median overall survival from time of cancer and UEDVT diagnoses was 29.6 and 13.25 months, respectively. In conclusion, UEDVT is an uncommon event. Around 50% developed a complication including PE, SVC or postthrombotic syndromes. Larger studies are needed to better identify risks associated with thrombosis and the best therapeutic approach and duration in this unique subset of patients with cancer.

• anticoagulation
• cancer
• central venous catheter
• thrombosis
• upper extremity

• Adult
• Aged
• Aged, 80 and over
• Central Venous Catheters/adverse effects
• Disease-Free Survival
• Electronic Health Records
• Female
• Humans
• Male
• Middle Aged
• Neoplasms/mortality
• Neoplasms/therapy
• Survival Rate
• Venous Thrombosis/etiology
• Venous Thrombosis/mortality

• Anticoagulants
• Cancer
• Hemorrhage
• Low-molecular-weight heparin
• Upper extremity deep vein thrombosis

• bilateral subclavian vein thrombosis
• paget–schroetter syndrome

• Adult
• Anticoagulants/therapeutic use
• Computed Tomography Angiography
• Drug Therapy, Combination
• Hepatitis/complications
• Hepatitis/diagnosis
• Hepatitis/drug therapy
• Humans
• Jugular Veins
• Liver Function Tests
• Male
• Silymarin/therapeutic use
• Subclavian Vein
• Upper Extremity Deep Vein Thrombosis/diagnosis
• Upper Extremity Deep Vein Thrombosis/drug therapy
• Venous Thrombosis/diagnosis
• Venous Thrombosis/drug therapy

• CICC
• PICC
• central catheters
• mortality
• thrombosis

• Aged
• Aspirin/therapeutic use
• Cardiology/standards
• Comorbidity
• Compression Bandages
• Elective Surgical Procedures/adverse effects
• Humans
• Incidence
• Lower Extremity
• Middle Aged
• Orthopedics
• Pulmonary Embolism/epidemiology
• Pulmonary Embolism/etiology
• Risk Factors
• Upper Extremity
• Upper Extremity Deep Vein Thrombosis/epidemiology
• Upper Extremity Deep Vein Thrombosis/etiology
• Venous Thrombosis/epidemiology
• Venous Thrombosis/etiology

• Anticoagulants/therapeutic use
• Arm/blood supply
• Humans
• Incidence
• Male
• Pulmonary Embolism/etiology
• Ultrasonography
• Venous Thrombosis/diagnosis
• Venous Thrombosis/diagnostic imaging
• Venous Thrombosis/drug therapy

• Anticoagulant therapy
• Bleeding complications
• Central venous catheter (CVC)
• Mortality
• Neoplasms
• Recurrent venous thromboembolism (VTE)
• Upper extremity deep vein thrombosis (UEDVT)

• upper limb
• venous thrombosis

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Catheterization, Peripheral/adverse effects
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Humans
• Incidence
• Infant
• Infant, Newborn
• Male
• Middle Aged
• New South Wales/epidemiology
• Retrospective Studies
• Risk Factors
• Tertiary Care Centers
• Ultrasonography, Doppler, Duplex/methods
• Upper Extremity/blood supply
• Vascular Access Devices/adverse effects
• Venous Thrombosis/diagnosis
• Venous Thrombosis/epidemiology
• Venous Thrombosis/etiology
• Young Adult

• Catheterization, Central Venous/adverse effects
• Central Venous Catheters/adverse effects
• Female
• Humans
• Male
• Risk Factors
• Upper Extremity Deep Vein Thrombosis/diagnosis
• Upper Extremity Deep Vein Thrombosis/pathology
• Upper Extremity Deep Vein Thrombosis/therapy

• anticoagulation
• sickle cell disease
• upper-extremity deep-vein thrombosis

• Adult
• Baseball
• Diagnosis, Differential
• Humans
• Male
• Tenodesis/adverse effects
• Upper Extremity/blood supply
• Upper Extremity Deep Vein Thrombosis/diagnosis
• Venous Thrombosis/diagnosis
• Venous Thrombosis/etiology