Upper Extremities Deep Vein Thrombosis in Cancer Patients: Complications and Treatment

Background and aims: Venous Thromboembolism (VTE) risk is 4-fold increase in patients with cancer. Upper Extremities deep vein thrombosis (UEDVT) is less common than the lower extremities’ one. One of the leading cause of UEDVT in cancer patients is the use of central venous catheters (CVC). Patients and methods: we analysed retrospectively 21 cancer patients with UEDVT diagnosed at our diagnostic centre, from 2016 up to 2020. Results: the more frequent types of cancers were lymphoma and breast cancer (both 28,5%). The most frequently involved vessel was subclavian vein (71,4%). As regards the treatment 52,4% of patients was treated with LMWH, 14,3% with fondaparinux, 52,4% with DOAC. There were no cases of pulmonary embolism, while post thrombotic syndrome (PTS) was detected in 33.3%. Thrombotic recurrence was observed in 19% of the patients. As regards the adverse events related to the therapy, we observed one case of major bleeding, with LMWH, with consequent drug withdrawal and two cases of minor bleeding, not requiring drug withdrawal. Conclusions: in our population UEDVT was not complicated by pulmonary embolism, but we could observe a significant incidence of PTS. Moreover, anticoagulation and even DOACs appear safe even in this frail kind of patients. References 1. Falanga A, Marchetti M, Vignoli A (2013) Coagulation and cancer: biological and clinical aspects. J Thromb Haemost 11: 223-233. 2. Khorana AA (2011) Risk assessment and prophylaxis for VTE in cancer patients. J Natl Compr Canc Netw 9: 789-797. 3. Munoz FJ, Mismetti P, Poggio R, Valle R, Barrón M, et al (2008) Clinical outcome of patients with upper extremity deep vein thrombosis: results from the RIETE registry. Chest 133: 143-148. 4. Bleker, van Es N, van Gils L, Daams JG, Kleinjan A, et al. (2016) Clinical Course of upper extremity deep vein thrombosis in patients with or without cancer: a systematic review. Thromb Res 140 (suppl 1): S81-S88.

PDF HTML