Extra-abdominal venous thromboses at unusual sites

Best Pract Res Clin Haematol. 2012 Sep;25(3):265-74. doi: 10.1016/j.beha.2012.07.003. Epub 2012 Aug 11.

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.

Publication types

  • Review

MeSH terms

  • Anticoagulants / pharmacology
  • Anticoagulants / therapeutic use
  • Catheters / adverse effects
  • Contraceptives, Oral / adverse effects
  • Heparin / pharmacology
  • Heparin / therapeutic use
  • Humans
  • Postthrombotic Syndrome / diagnosis
  • Postthrombotic Syndrome / drug therapy
  • Postthrombotic Syndrome / etiology
  • Postthrombotic Syndrome / pathology*
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / drug therapy
  • Pulmonary Embolism / etiology
  • Pulmonary Embolism / pathology*
  • Retinal Vein Occlusion / diagnosis
  • Retinal Vein Occlusion / drug therapy
  • Retinal Vein Occlusion / etiology
  • Retinal Vein Occlusion / pathology*
  • Risk Factors
  • Thrombophilia / diagnosis
  • Thrombophilia / drug therapy
  • Thrombophilia / etiology
  • Thrombophilia / pathology*
  • Upper Extremity Deep Vein Thrombosis / diagnosis
  • Upper Extremity Deep Vein Thrombosis / drug therapy
  • Upper Extremity Deep Vein Thrombosis / etiology
  • Upper Extremity Deep Vein Thrombosis / pathology*
  • Vitamin K / antagonists & inhibitors
  • Warfarin / pharmacology
  • Warfarin / therapeutic use

Substances

  • Anticoagulants
  • Contraceptives, Oral
  • Vitamin K
  • Warfarin
  • Heparin