“Venous thromboembolism (VTE), which includes deep venous thrombosis (DVT) and pulmonary embolism (PE), is the third most common cardiovascular disorder with an annual incidence of 0.1%, affecting approximately 5% of the population.1 Upper extremity DVT (UEDVT) has been thought to account for 4e10% of all cases of DVT and may involve the radial, ulnar, brachial, axillary, subclavian, brachiocephalic, or internal jugular veins.
Historically, UEDVT has been considered a relatively benign event. However, as the incidence of UEDVT increases, so do its subsequent complications including PE, venous access difficulties, superior vena cava syndrome, postthrombotic syndrome, and bleeding on therapeutic anticoagulation therapy, suggesting an insufficient understanding and management of UEDVT.
Management guidelines, with the exception of those for thoracic outlet syndrome, are largely
extrapolated from lower extremity DVT (LEDVT) and PE management.”

“UEDVT is less common than LEDVT, and as a result, there is little data directly comparing the 2 entities. To the best of our knowledge, this study is novel in its assessment of the characteristics and outcomes of the UEDVT population as it compares to LEDVT
specifically in an inpatient population. We found the prevalence of UEDVT to be higher than expected in hospitalized patients, that patients with UEDVT tend to be more comorbid and present more commonly with catheter-associated VTE. We also found that despite a lower incidence of PE, patients with UEDVT had higher all-cause mortality (28.5%), greater than the 11% UEDVT 3-month mortality previously published by the RIETE registry, which includes inpatient and outpatient VTEs. Importantly, a significant difference in mortality persisted with the exclusion of patients with catheter-related UEDVT. These data do not suggest that UEDVT is itself a direct cause of higher mortality seen in this population. Rather, increased mortality in patients with UEDVT may suggest an overall increased thrombotic risk or, further, a more severe global inflammatory state in these patients. Alternatively UEDVT may be a surrogate marker for a sicker patient population with higher mortality rate.
Larger studies investigating the se findings could improve identification of factors associated with increased risk for development of UEDVT as well as identify patients that may benefit from more aggressive treatment.”

Rokosh, Rae S et al. “High Prevalence and Mortality Associated with Upper Extremity Deep Venous Thrombosis in Hospitalized Patients at a Tertiary Care Center.” Annals of vascular surgery vol. 65 (2020): 55-65. doi:10.1016/j.avsg.2019.10.055