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Traumatic Thrombosis of the Axillary Vein

Traumatic Thrombosis of Axillary Vein


Presentation

  • If emboli form, break off, and travel distally, patients may present with subacute focal symptoms such as an individual digit with decreased pallor. 11 The most dangerous presentation is in patients who acutely form a completely thrombosed subclavian[clinicaladvisor.com]
  • After 10 days, she presented to accident and emergency department with acute discomfort and swelling of the left upper extremity.[ijcasereportsandimages.com]
  • He presented to us with an acute onset (two days history) of left upper extremity pain, edema, and bluish discoloration.[cathlabdigest.com]
  • We present a 53 year-old female that complained of a progressive painful left lower neck swelling and redness for 2 days.[ispub.com]
  • Although most patients present with pain, swelling, parathesias, and prominent veins throughout the arm or shoulder, many patients will not display any local DVT symptoms.[the-hospitalist.org]
Surgical Procedure
  • Improper utilization of appliances and conventional surgical procedures for common orthopedic conditions has on occasion likewise been followed by disastrous vascular complications.[books.google.de]
  • Damage to veins resulting from recent trauma or surgery Slowing or obstruction of the flow of venous blood Being in a hypercoagulable state (increased clotting) History of previous injury or immobilization Recent history of surgical procedure Inherited[ksi.uconn.edu]
  • It has been reported that the combined approach improves long-term results and decreases recurrence rates. 13 Complications of surgical procedures in these cases include injury to major neurovascular structures, which can be avoided with careful manipulation[clinicaladvisor.com]
  • Patients with confirmed DVT and an obvious cause (eg, immobilization, surgical procedure, leg trauma) need no further testing.[merckmanuals.com]
  • Sometimes, if there is a large artery that is occluded, this test is done in the operating room with the presumption that a surgical procedure will be necessary to open the vessel and restore blood flow.[emedicinehealth.com]
Arm Pain
  • Patients present with symptoms and signs of an upper limb deep vein thrombosis (i.e. arm pain and swelling). Compression of the subclavian vein when it passes through the costoclavicular space is the most favored mechanism of thrombosis.[radiopaedia.org]
  • Upon subjective assessment the patient reported very high levels of progressively worsening diffuse shoulder and upper arm pain over the last 3-4 days with no known trigger or cause.[thesports.physio]
Pathologist
  • History and etymology The first detailed case was described by the British surgeon and pathologist Sir James Paget (1814-1899) 4 in 1875.[radiopaedia.org]
Vascular Disease
  • Springer Science & Business Media, 06.12.2012 - 404 Seiten That a close relationship exists between the specialties of peripheral vascular diseases and of orthopedic and general surgery has frequently been brought sharply into focus for both of us during[books.google.de]
  • You are more likely to have vascular disease as you get older.[icdlist.com]
  • :Allen-Barker-Hines, Peripheral vascular diseases, Saunders, Philadelphia, 1972. 11) Gillespie, J. A., and Douglas, D. M. :Some aspects of obliterative vascular disease of the lower limb, Livingstone, Edinburgh, 1961. 12) Gillespie, J. A.[molcom.jp]
  • VASCULAR DISEASE MANAGEMENT 2010;7:E175–E177 Key words: Paget-Schröetter syndrome; deep venous thrombosis; exercise __________________________________________________ Case Report A 24-year-old right-handed lawyer presented with a 3-day history of painless[vasculardiseasemanagement.com]
  • The risk factors for arterial clot are those commonly associated with heart attack, peripheral vascular disease , and stroke.[emedicinehealth.com]

Workup

  • Occult cancers may be present in patients with apparently idiopathic DVT, but extensive workup of patients for tumors is not recommended unless patients have major risk factors for cancer or symptoms suggestive of an occult cancer.[merckmanuals.com]
Right Pleural Effusion
  • A chest x-ray indicated moderate right pleural effusion. Cefazolin was administered for a possible cellulitis, and a further testing was initiated to evaluate the pleural effusion.[ispub.com]

Treatment

  • For the treatment of VTE, rivaroxaban is given orally at 15 mg twice a day for the initial 21 days of treatment, followed by once daily at 20 mg per day for long-term treatment.[clevelandclinicmeded.com]
  • Dabigatran 150 mg po bid is given only after an initial 5 to 7 days of treatment with LMWH. Duration of treatment varies.[merckmanuals.com]
  • TREATMENT Contemporary treatment of PSS varies widely in medical practice. There is no strict consensus on treatment and there are several strategies in parallel use, however most cases rely on conservative treatment.[aspetar.com]
  • Treatment with blood thinners usually lasts for 6 months, however – If your blood clot occurred after a short-term risk like surgery, treatment time may be shorter If you have a history of blood clots, treatment time may be longer Thrombin inhibitors[ksi.uconn.edu]
  • She should continue warfarin treatment for at least three months, with a goal INR of 2.0 to 3.0, similar to treatment for LEDVT. The ultimate treatment duration with warfarin follows the same guidelines as treatment with a LEDVT.[the-hospitalist.org]

Prognosis

  • Treatment and prognosis The thrombus is treated with anticoagulation and catheter-directed thrombolysis, after which surgical decompression is performed.[radiopaedia.org]
  • What are the symptoms, treatment, and prognosis for phlebitis? Pain, swelling, redness, and tenderness are some common symptoms of phlebitis.[medicinenet.com]
  • Prognosis Associated with significant morbidity and mortality due to potential risks of pulmonary embolism, post-thrombotic syndrome and loss of vascular access. About 10-20% develop pulmonary embolism [ 9 ].[patient.info]
  • The prognosis is poor but not so grave as before antibiotic therapy. thrombosis, coronary , n thrombosis of the coronary artery; also called heart attack and coronary occlusion. thrombosis formation, development, or presence of a thrombus.[medical-dictionary.thefreedictionary.com]
  • However, its presence should alert hospitalists to the patient's potentially poorer prognosis and prompt evaluation for occult malignancy if no risk factor is present.[the-hospitalist.org]

Etiology

  • Diligent searches for underlying etiology may be prompt due to the association of malignancies presenting in such a matter in adults.[ispub.com]
  • There were diagnostic difficulties in determining the definitive etiology of the axillary vein thrombosis.[ingentaconnect.com]
  • Etiology Trauma (particularly after an operation and parturition), cardiac and vascular disorders, obesity, hereditary coagulation disorders, age over 65, an excess of erythrocytes and of platelets, an overproduction of fibrinogen, and sepsis are predisposing[medical-dictionary.thefreedictionary.com]
  • Etiology Twenty percent of cases of upper-extremity DVT are of primary etiology.[acphospitalist.org]
  • Hence, there is an urgent need for increasing physician awareness about risk factors, etiology and the management of this unique and relatively infrequent disorder.[westjem.com]

Epidemiology

  • Deep vein thrombosis of the axillary-subclavian veins: epidemiologic data, effects of different types of treatment and late sequelae. Eur J Vasc Surg 1988; 2:161. Isma N, Svensson PJ, Gottsäter A, Lindblad B.[jmscr.igmpublication.org]
  • Epidemiology [ 1 ] There is a low incidence of about 1 per 100,000 people per year. 4-10% of all deep vein thromboses (DVTs) occur in the upper extremity.[patient.info]
  • Lindblad B, Tengborn L, Bergqvist D: Deep vein thrombosis of the axillary-subclavian veins: epidemiologic data, effects of different types of treatment and late sequelae. Eur J Vasc Surg 1988;2:161–165.[karger.com]
  • Deep vein thrombosis of the axillary-subclavian veins: epidemiologic data, effects of different types of treatment and late sequelae. Eur J VascSurg. 1988;2(3):161-5. PubMed Google Scholar Coon WW, Willis PW 3rd.[panafrican-med-journal.com]
  • Kahn, MD, Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Canada Acknowledgement: Review of manuscript: Elizabeth Varga, Columbus, OH; Graphic Design: Jeff Harrison, Wilmington, NC.[stoptheclot.org]
Sex distribution
Age distribution

Pathophysiology

  • Critical review of pathophysiologic mechanisms in thoracic outlet syndrome (TOS). Acta Neurochir Suppl 2007; 100:137. Mustafa S, Stein PD, Patel KC, et al. Upper extremity deep venous thrombosis. Chest 2003; 123:1953. Paget, J.[jmscr.igmpublication.org]
  • In the ED, about half of all patients with PE have a heart rate greater than 100 beats/min. 11 Tachycardia from PE probably results from impaired left ventricular filling, leading to a pathophysiologic process that parallels that of hemorrhagic shock.[clinicalgate.com]
  • […] described are estrogen ingestion, pregnancy, intravenous catheters, anti-neoplastic agents, and pacemakers. [2] Although, early clinical recognition of UEDVT is important, diagnosis may be difficult because of its indeterminate cause and indistinct pathophysiology[jmedsoc.org]
  • Pathophysiology is unclear, but edema may increase soft-tissue pressure beyond capillary perfusion pressures, resulting in tissue ischemia and wet gangrene.[merckmanuals.com]
  • Pathophysiology The main pathophysiological issue after vascular injuries to the extremities is ischemia. The process is identical to what happens during acute leg ischemia due to embolization.[intranet.tdmu.edu.ua]

Prevention

  • How can you prevent phlebitis? Simple measures can be taken to prevent phlebitis, although, sometimes it cannot be avoided.[medicinenet.com]
  • The authors found that ultrasound was more cost-effective than VCF, with a cost per PE prevented of 46,3000 versus 97,000.[east.org]
  • Diagnosis is usually confirmed with an ultrasound. [7] These DVTs have the potential to cause a pulmonary embolism. [8] Diagnosis [ edit ] Duplex ultrasonography MR Venography Prevention [ edit ] Preventing the development of blood clots in the upper[en.wikipedia.org]
  • They probably play a role in the prevention of stasis and should be combined with other methods to prevent thromboembolism.[medical-dictionary.thefreedictionary.com]
  • Prevention Sitting during a long flight or car ride can cause your ankles and calves to swell and increases your risk of thrombophlebitis. To help prevent a blood clot: Take a walk.[mayoclinic.org]

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