Upper extremity DVT in oncological patients: analysis of risk factors. Data from the RIETE registry.
OBJECTIVE
The aim of the study is to up date informations on the clinical characteristics and outcome of patients with upper-extremity deep vein thrombosis (DVT) from the Informatised Registry on Venous Thromboembolism (RIETE).


METHODS
RIETE is an ongoing registry of consecutive patients with symptomatic, objectively confirmed, acute venous thromboembolism. In this analysis the clinical characteristics and 3-month outcome of all cancer patients with upper-extremity DVT were evaluated.


RESULTS
Up to February 2006, a total of 14,391 patients with symptomatic, objectively confirmed acute venous thromboembolism had been enrolled in RIETE. Of the 2,945 patients with active cancer 196 (6.7%) had arm DVT: 104 had catheter-associated DVT. Most cancer patients with arm DVT were males, younger than 65, and had a low incidence of additional risk factors or underlying diseases. Twenty of them (10%) had symptomatic pulmonary embolism (PE). Most patients were treated with low-molecular-weigh heparin, both initially (94%) and after discharge (75%). During the 3-month follow-up period 12 patients (6.1%) developed VTE recurrences (PE 6, DVT 6), 8 (4.1%) had major bleeding (fatal in 3), 43 (22%) died.


CONCLUSIONS
Our data from the RIETE registry show that upper limb DVT is a serious complication in patients with cancer, with a high incidence of recurrences and bleeding complications.
Monreal
M
M
Internal Medicine Division, Hospital of Germans Trias i Pujol University, Badalona, Spain. mmonreal.germanstrias@gencat.net
Munoz
F J
FJ
Rosa
V
V
Romero
C
C
Roman
P
P
Di Micco
P
P
Prandoni
P
P
D000328:Adult; D001132:Arm / Q000098:blood supply*; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D013577:Syndrome; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply; D020246:Venous Thrombosis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*
D006495:Heparin, Low-Molecular-Weight