title: Extra-abdominal venous thromboses at unusual sites.
abstract: Venous thrombosis typically involves the lower extremities. Rarely, it can occur in cerebral, splanchnic, or renal veins, with a frightening clinical impact. Other rare manifestations are upper-extremity deep vein thrombosis, that can complicate with pulmonary embolism and post-thrombotic syndrome, and retinal vein occlusion, significantly affecting the quality of life. This review is focused on venous thromboses at unusual extra-abdominal sites. Local infections or cancer are frequent in cerebral sinus-venous thrombosis. Upper-extremity deep vein thrombosis is mostly due to catheters or effort-related factors. Common risk factors are inherited thrombophilia and oral contraceptive use. Acute treatment is based on heparin; in cerebral sinus-venous thrombosis, local or systemic fibrinolysis should be considered in case of clinical deterioration. Vitamin-K antagonists are recommended for 3-6 months; indefinite anticoagulation is suggested for recurrent thrombosis or unprovoked thrombosis and permanent risk factors. However, such recommendations mainly derive from observational studies; there are no data about long-term treatment of retinal vein occlusion.
authors.affiliation: Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Internal Medicine and Medical Specialities, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy. martin@policlinico.mi.it
authors.forename: Ida
authors.initials: I
authors.lastname: Martinelli
authors.forename: Valerio
authors.initials: V
authors.lastname: De Stefano
mesh_terms: D000925:Anticoagulants / Q000494:pharmacology / Q000627:therapeutic use; D057785:Catheters / Q000009:adverse effects; D003276:Contraceptives, Oral / Q000009:adverse effects; D006493:Heparin / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D054070:Postthrombotic Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D012170:Retinal Vein Occlusion / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D012307:Risk Factors; D019851:Thrombophilia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D056824:Upper Extremity Deep Vein Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D014812:Vitamin K / Q000037:antagonists & inhibitors; D014859:Warfarin / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D003276:Contraceptives, Oral; D014812:Vitamin K; D014859:Warfarin; D006493:Heparin