TY - JOUR
T1 - Characterizing resolution of catheter-associated upper extremity deep venous thrombosis
AU - Jones, Mark A.
AU - Lee, Dae Y.
AU - Segall, Jocelyn A.
AU - Landry, Gregory J.
AU - Liem, Timothy K.
AU - Mitchell, Erica L.
AU - Moneta, Gregory L.
PY - 2010/1
Y1 - 2010/1
N2 - Objective: Catheter-associated upper extremity deep venous thrombosis (CAUEDVT) is well known; however, resolution rates and factors affecting resolution of CAUEDVT are not well characterized. This study determined resolution rates and factors associated with resolution of CAUEDVT. Methods: From January 1, 2002, to June 30, 2006, 1761 upper extremity venous duplex ultrasound (DU) studies were performed, and a new UEDVT was found in 253 (14.4%). Of these, 150 patients had routine follow-up and 101 had CAUEDVT. Demographics, follow-up DU results, and risk factors for venous thrombosis were recorded in the patients with follow-up studies and CAUEDVT. Univariate analysis and multivariate logistic regression analysis was performed to determine independent risk factors for complete thrombus resolution. Results: There were 49 men (49%) and 52 women (51%) with CAUEDVT and follow-up studies. Mean age was 49 years (range, 5 months-80 years). Patients with CAUEDVT had risk factors for venous thrombosis that included malignancy in 34%, recent surgery/trauma in 34%, known hypercoagulable state in 11%, concomitant lower extremity DVT in 21%, and pulmonary embolism in 5%. Complete resolution of DVT on follow-up was documented in 46%. Thrombosis resolved in only 25% (6 of 24) when the catheter was not removed (P ≤ .05). Anticoagulation did not improve the rate of thrombus resolution (P ≤ 1.0) compared with catheter removal alone. Of the patients who had thrombus resolution, 75% resolved by 100 days (range, 1-914 days) after catheter removal ≤48 hours of diagnosis. In multivariate analysis, only catheter removal predicted the likelihood of thrombus resolution (odds ratio, 3.25; 95% confidence interval, 1.16-9.09; P = .025). New-site UEDVT developed in 86% of patients with CAUEDVT who underwent catheter removal and immediate catheter placement in a new site. Pulmonary embolism developed in five patients with CAUEDVT. Of these, three had documented lower extremity DVT as well. No pulmonary emboli were fatal. Conclusions: More than half of CAUEDVT resolve ≤113 days when the catheter is removed ≤48 hours of diagnosis. New-site catheter placement has a high rate of new associated UEDVT. Anticoagulation does not appear to augment resolution of UEDVT.
AB - Objective: Catheter-associated upper extremity deep venous thrombosis (CAUEDVT) is well known; however, resolution rates and factors affecting resolution of CAUEDVT are not well characterized. This study determined resolution rates and factors associated with resolution of CAUEDVT. Methods: From January 1, 2002, to June 30, 2006, 1761 upper extremity venous duplex ultrasound (DU) studies were performed, and a new UEDVT was found in 253 (14.4%). Of these, 150 patients had routine follow-up and 101 had CAUEDVT. Demographics, follow-up DU results, and risk factors for venous thrombosis were recorded in the patients with follow-up studies and CAUEDVT. Univariate analysis and multivariate logistic regression analysis was performed to determine independent risk factors for complete thrombus resolution. Results: There were 49 men (49%) and 52 women (51%) with CAUEDVT and follow-up studies. Mean age was 49 years (range, 5 months-80 years). Patients with CAUEDVT had risk factors for venous thrombosis that included malignancy in 34%, recent surgery/trauma in 34%, known hypercoagulable state in 11%, concomitant lower extremity DVT in 21%, and pulmonary embolism in 5%. Complete resolution of DVT on follow-up was documented in 46%. Thrombosis resolved in only 25% (6 of 24) when the catheter was not removed (P ≤ .05). Anticoagulation did not improve the rate of thrombus resolution (P ≤ 1.0) compared with catheter removal alone. Of the patients who had thrombus resolution, 75% resolved by 100 days (range, 1-914 days) after catheter removal ≤48 hours of diagnosis. In multivariate analysis, only catheter removal predicted the likelihood of thrombus resolution (odds ratio, 3.25; 95% confidence interval, 1.16-9.09; P = .025). New-site UEDVT developed in 86% of patients with CAUEDVT who underwent catheter removal and immediate catheter placement in a new site. Pulmonary embolism developed in five patients with CAUEDVT. Of these, three had documented lower extremity DVT as well. No pulmonary emboli were fatal. Conclusions: More than half of CAUEDVT resolve ≤113 days when the catheter is removed ≤48 hours of diagnosis. New-site catheter placement has a high rate of new associated UEDVT. Anticoagulation does not appear to augment resolution of UEDVT.
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U2 - 10.1016/j.jvs.2009.07.124
DO - 10.1016/j.jvs.2009.07.124
M3 - Article
C2 - 19879094
AN - SCOPUS:72549110650
SN - 0741-5214
VL - 51
SP - 108
EP - 113
JO - Journal of vascular surgery
JF - Journal of vascular surgery
IS - 1
ER -