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Invited Commentary
May 2014

Upper Extremity Deep Vein Thrombosis: A Call to Arms

Author Affiliations
  • 1Department of Medicine, University of California, San Diego School of Medicine, San Diego

Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Intern Med. 2014;174(5):696-698. doi:10.1001/jamainternmed.2013.14014

Lamontagne et al1 present findings in this issue of JAMA Internal Medicine from a study focused on the epidemiology, management patterns, and clinical consequences of nonleg venous thrombosis. This prospective cohort study is nested in a large international trial (Prophylaxis for Thromboembolism in Critical Care Trial, aka, PROTECT) randomizing medical-surgical intensive care unit (ICU) patients to either unfractionated heparin or dalteparin for thromboprophylaxis. Of the 3746 patients, 84 (2.2%) experienced a total of 145 nonleg venous thromboses. Most thrombotic segments (94.5%) occurred in the upper extremity, and most thrombi occurred in the more clinically important deep vein distribution.