Whats the best way to manage upper extremity venous thrombosis?
A/ STANDARD MANAGEMENT IS BEST: Start with unfractionated heparin or low-molecular-weight heparin and follow with long-term therapy with a vitamin K antagonist (strength of recommendation [SOR]: C, expert consensus and case reports). Some evidence supports thrombolyric therapy, placement of a superior vena cava filter, or surgical thrombectomy in selected patients (SOR: C, expert consensus and case reports). Whether to remove venous catheters during initial treatment for catheter-induced venous thrombosis remains unclear, because limited studies address this issue specifically (SOR: C, expert consensus and case reports). Evidence summary Upper extremity venous thrombosis (UEVT)–which typically refers to thrombosis of the brachial, axillary, or subclavian veins–accounts for approximately 10% of all cases of venous thromboembolism. (1) UEVT can occur spontaneously (Paget-Schroetter syndrome) or develop as a complication of cancer or indwelling medical devices (such as long-term central
