Table 2.
Extant literature for treatment of UEDVT1
| Author year | Study type | Enrolled | Intervention | Outcomes | Follow‐up | Results |
|---|---|---|---|---|---|---|
| Savage 199910 | Prospective cohort, 2 center | 46 outpatients with UEDVT (16 CVC) |
Dalteparin 200 IU/kg daily for 5‐7 d and VKA with target INR 2.0‐3.0 Duration of VKA not provided |
Symptomatic recurrence/extension of DVT, PE, MB, death |
3 mo |
Recurrence/extension DVT: 1/46 (2%) PE: 0/46 MB: 1/46 (2%) (on VKA) Death: 7/46 (15%) (none from PE or bleeding) |
| Karabay 200411 | Prospective cohort, single center | 36 inpatients with UEDVT (includes 13 with CVC) | Nadroparin s.c. BID, 86 anti‐Xa IU/kg for 7 d then VKA (started on d 3; target INR 2‐2.5) for mean of 4.7 mo |
Symptom relief Lysis of thrombus on ultrasound Recurrent DVT PE Death |
12 mo |
Significant symptom relief, day 7: 32/36 (89%) Lysis, day 10: ≥35%: 16/36 (45%), <35%: 17/36 (47%) None: 3/36 (8%) Recurrent DVT: 0/36 PE: 0/36 Death: 9/36 (25%) (none due to PE or bleeding) |
| Prandoni 20049 | Prospective cohort, number of centers not stated | 53 patients with first UEDVT (included 6 with CVC) | Therapeutic‐dose heparin (81% received UFH, 19% received LMWH) then VKA (median, 3 mo) |
Recurrent VTE Death |
Median 48 mo |
Results not presented by initial Rx with UFH vs. LMWH Recurrent VTE: 3/53 (5.7%) (2 arm, 1 leg) Cumulative incidence 1, 2, and 5 y: 2.0%, 4.2%, 7.7% Death: 11/53 (20.8%) (due to cancer, PE, congestive heart failure [numbers not provided]) |
| Kovacs 200745 | Prospective cohort, multicenter | 74 cancer patients with UEDVT (all had CVC) |
Dalteparin 200 IU/kg daily for 5‐7 d and VKA to achieve target INR of 2.0‐3.0 |
Recurrent VTE, PE, MB, death, CVC failure 2/2 DVT or inability to infuse | 3 mo |
Recurrent VTE: 0/74 PE: 0/74 MB: 3/74 (4%) Death: 7/74 (6 cancer, 1 MB) Catheter failure due to DVT or inability to infuse: 0/74 |
| Baumann‐Kreuziger 201546 | Subset of prospective international registry of consecutive patients with objectively confirmed VTE | 558 (all had CVC and thrombosis and 45 had concomitnant PE at time of CVC‐related DVT) | LMWH 67%, VKA 27% |
VTE recurrence MB |
Median 106 d |
Recurrent VTE: 7/100 pt‐years MB: 8.9/100 pt‐years Fatal PE: 1.85/100 pt‐years Fatal bleeding: 2.32/100 pt‐years |
| Delluc 201447 | Retrospective cohort study | 89 consecutive cancer outpatients with UEDVT (all CVC related) | 1 mo of full therapeutic weight‐adjusted dose of LMWH followed by an intermediate dose |
VTE recurrence MB |
Mean 124 d |
Recurrent VTE: 0/89 MB: 2/89 |
| Laube 201748 | Retrospective cohort | 83 cancer patients (53 completed 90‐d) with CVC and UEDVT | Rivaroxaban (Dosing not reported) | Line function, line removal, bleeding, death, other VTE | 90 d |
Preserved line function: 50/53 MB: 2/53 CRNMB: 1/53 Death: 6/53 New VTE: 3/53 |
| Davies 201829 | Prospective cohort, multicenter | 70 consecutive cancer patients with UEDVT (all CVC related) | Rivaroxaban 15 mg BID for 21 d then 20 mg daily for 9 wk | Line function, recurrent VTE, bleeding | 12 wk |
Preserved line function: 100% Recurrent VTE: 1.43% (1/70) Bleeding: 12.9% |
Table 2 is constructed in part from AT9 Table S46.
CRNMB, clinically relevant nonmajor bleeding; CVC, central venous catheter; DVT, deep vein thrombosis; INR, international normalized ratio; LMWH, low‐molecular‐weight heparin; MB, major bleeding; PE, pulmonary embolism; UEDVT, upper extremity deep vein thrombosis; UFH, unfractionated heparin; VKA, vitamin K antagonist; VTE, venous thromboembolism.