Post-thrombotic syndrome (PTS) is one of the main complications that occurs after venous thrombosis. There is little data on the proportion of patients that will develop upper extremity PTS (UE-PTS) after upper extremity venous thrombosis (UEVT). The main objective of the study was to assess the prevalence of PTS in a UEVT cohort and to identify predictive factors of UE-PTS.
This study included patients with a history of proximal or arm UEVT, diagnosed on duplex ultrasound between January 1, 2015 and December 31, 2017 in a University Hospital. After UEVT, each patient was evaluated by a prospective standardized recording of clinical manifestations and duplex ultrasound in case of upper limb symptoms. UE-PTS was defined as a modified Villalta score ≥4.
Ninety-two patients were included, 68 (73.9%) had deep vein thrombosis (DVT) and 24 (19.2%) arm superficial vein thrombosis (SVT). Thirteen patients had PTS (14.1%); 12 (17.6%) in the DVT group and 1 (4.2%) in the SVT group; there was a history of DVT in 92.3% of the cases of PTS. PTS was more frequent in patients with strokes with limb movement reduction (p=0.01). In multivariate Cox analysis, a history of stroke (HR: 5.4; [1.46; 20.22], p=0.01) was a predictive factor of UE-PTS.
UE-PTS occurred in 14.1% of the cases after UEVT. Stroke with reduction of limb movement was a predictor of developing post-thrombotic syndrome. Diagnostic criteria should be established for UE-PTS and prospective studies are needed to improve the description and management of UE-PTS.

Copyright © 2021. Published by Elsevier Inc.

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