Asiye KANBAY, Metin ÖZKAN, Yiğit AKÇALI, Hakan BÜYÜKOĞLAN, Fatma Sema OYMAK, Ökkeş İbrahim KARAHAN, İnci GÜLMEZ, Ramazan DEMİR

The prevalence of upper extremity deep venous thrombosis

Amaç: Bu çalışmada, üçüncü basamak bir sağlık kurumunda semptomatik üst ekstremite derin ven trombozlarının (ÜEDVT) prevalansı, özellikleri ve semptomatik pulmoner emboli (PE) ile birlikteliğinin belirlenmesi amaçlandı. Çalışma planı: Bir üniversite hastanesinde Ocak 2001 ve Aralık 2003 tarihleri arasında son üç yıllık dönem içindeki semptomatik ÜEDVT prevalansı geriye dönük olarak değerlendirildi. Hastalar hastane kayıtlarından tespit edildi ve üst ekstremitelerin manyetik rezonans anjiyografileri, venografileri ve renkli Doppler ultrasonografileri ise bilgisayarda kayıtlı listelerden elde edildi. Veriler, tıbbi kayıtlar ve hasta takip anketlerinden elde edildi. Bulgular: Tüm yaş grupları için semptomatik ÜEDVT tanısı 100.942 hastanın 91’inde (%0.09) [veya 20 yaş ≥70.751 erişkin hastanın 89’unda; %0.13] kondu. Üst ekstremite derin ven trombozları olan 91 hastadan 73’ünde (%80) çoklu risk faktörleri var idi; 33 hastada (%36) malignansi, 34 hastada (%37) santral venöz kateter (SVK), periferik venöz yol (PVY) ve kardiyak pacemaker (n=1), 36 hastada (%40) kronik hastalıklar (kronik obstrüktif akciğer hastalığı, kalp hastalığı, hemodiyaliz tedavisi gören kronik böbrek yetmezliği, 12 hastada (%13) travma veya cerrahi, 53 hastanın 13’ünde (%24) trombofili ile ilişkili sekonder ÜEDVT var idi. Semptomatik PE 32 hastada (%35) tromboz tedavisinden önce gelişti. Başlangıçta diğer yöntemler ile tedavi edilen 13 hasta (5; trombolitik tedavi, 8 trombektomi) dışındaki tüm hastalar antikoagülan tedavi aldı. Sonuç: Üst ekstremite derin ven trombozu nadir görülen bir patoloji değildir. Etyolojisi sıklıkla multifaktöriyel olup, trombofili, SVK, PVY, kronik hastalıklar ve kansere sekonderdir. ÜEDVT’den kaynaklanan PE sık görülen bir komplikasyon olduğundan, risk faktörlü hastalar erken tanılanmalı ve tedavi edilmelidir.

Üst ekstremite derin ven trombozu prevalansı

Background: This study aims to determine the prevalence and characteristics of symptomatic upper extremity deep venous thrombosis (UEDVT) and its association with symptomatic pulmonary embolism (PE) in a tertiary care hospital. Methods: Between January 2001 and December 2003, the prevalence of symptomatic UEDVT at a university hospital within the past three-years was evaluated retrospectively. Patients were identified by hospital records, and a computerrecorded list of all color Doppler ultrasonograms, venograms, and magnetic resonance angiograms of upper extremities was also used. Data were obtained from medical records and follow-up patient questionnaires. Results: Symptomatic UEDVT was diagnosed in 91 of 100.942 patients of all ages (0.09%) [or 89 of 70.751 of adult patients ≥20 years of age; 0.13%]. Seventy three (80%) of 91 patients with UEDVT had multiple risk factors; 33 patients (36%) had malignancy, 34 patients (37%) had central venous catheters (CVCs), peripheral venous lines (PVLs) and cardiac pacemaker (n=1), 36 patients (40%) had chronic disorders (chronic obstructive pulmonary disease, cardiac disease, chronic renal failure with hemodialysis), 12 patients (13%) had trauma or surgery, 13 of 53 patients (24%) had UEDVT secondary to thrombophilia. Symptomatic PE developed prior to thrombosis being treated in 32 patients (35%). All patients received anticoagulant therapy except 13 patients (5 with thrombolytic therapy; 8 with thrombectomy) who were treated with other methods initially. Conclusion: Upper extremity deep venous thrombosis is not a rarely seen pathology. Its etiology is usually multifactorial and secondary to thrombophilia, CVC, PVL, chronic diseases and cancer. As PE resulting from UEDVT is a common complication, patients with risk factors should be diagnosed and treated early.

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