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C-2473 - Venous Causes of Upper Limb Swelling: A Pictorial Review

G. Chow, T. Armstrong, J. Kumaradevan; London/UK Type: Educational Exhibit
Area of Interests: Interventional vascular, Vascular, Anatomy
Imaging Techniques: Ultrasound, Catheter venography, CT-Angiography
Procedures: Thrombolysis, Angioplasty, Diagnostic procedure
Special Focuses: Obstruction / Occlusion, Embolism / Thrombosis, Edema
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Learning objectives: Discuss the aetiology of upper limb swelling due to venous thrombosis, including thoracic outlet syndrome (Paget-Schrotter syndrome), iatrogenic causes and thrombosis secondary to thrombophilia. Review diagnostic imaging techniques, with examples from our institution. Consider treatment pathways for[...]

Background: Upper limb deep vein thrombosis (DVT) is less recognised than its lower limb counterpart however accounts for approximately 10% of all DVTs, with an incidence of 2-3 per 100,000 (1,2). Its lower incidence can be attributed to multiple factors including fewer valves (3) and increased fibrinolytic act[...]

Findings and procedure details: It is important to understand firstly the difference between primary and secondary venous thrombosis. Primary includes idiopathic, thoracic outlet syndrome and effort thrombosis (Paget-Schroetter syndrome); secondary can be iatrogenic (for example central venous catheter or pacemaker lead), traumati[...]

Conclusion: After reading this review, delegates should have an improved understanding of the various underlying factors which can lead to venous thrombosis and subsequent upper limb swelling. The importance of recognising and diagnosing these causes is to allow timely intervention to prevention of complic[...]

Personal information: Dr Geoffrey Chow Radiology Trainee Royal Free Hospital Dr Thomas Armstrong Radiology Trainee  Royal Free Hospital   Dr Jeevan Kumaradevan Consultant Radiologist Whittington Hospital

References: (1) Kucher N. Clinical practice. Deep-vein thrombosis of the upper extremeties. N Engl J Med. 2011;364(9):861-9. (2) Joffe HV, Kucher N, Tapson VF, Goldhaber SZ. Deep Vein Thrombosis (DVT) FREE Steering Committee. Upper-extremity deep vein thrombosis: A prospective registry of 592 patients.&nb[...]

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