Predictability of symptoms of upper extremity deep venous thrombosis in patients with central venous catheters with color duplex imaging

J. M. Stanley, R. S. McGrath, Michael Freeman, Scott Stevens, Mitchell Goldman

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Abstract

Venous catheter placement, causing trauma to the vein wall, is considered a risk factor for deep venous thrombosis (DVT). Upper extremity DVT, occurring in only 1-3% of all diagnosed DVT, is potentially fatal and may be caused by indwelling venous catheters used for physiologic monitoring. The purpose of this study is to correlate the symptoms, with color duplex diagnosis, of upper extremity DVT in patients with central venous catheters. From January 1 to December 15, 1992, 25 patients with a recent history of central venous catheter placement were referred to the vascular laboratory to rule out upper extremity DVT. DVT was determined by color duplex imaging with attention to flow characteristics and vein compressibility. Of the 25 patients, 48% (12 of 25) were positive for DVT. Eight patients presented with a combination of ipsilateral arm pain and swelling of whom 6 (75%) had DVT. Of the other 17 patients who presented with a single symptom of either pain, swelling, dyspnea, hypoxia, or hand pain, 35% (6 of 17) were positive for DVT. The positive predictive value of using a combination of pain and swelling to predict upper extremity DVT in patients with central venous catheters was 75% with a negative predictive value of 65% (sensitivity = 50%, specificity = 85%, accuracy = 68%). The data from this study suggest that in patients with central venous catheters, (1) a combination of pain and swelling has a high correlation with upper extremity DVT while (2) any one symptom alone has a low correlation with upper extremity DVT diagnosed by color duplex imaging.

Original languageEnglish (US)
Pages (from-to)71-73
Number of pages3
JournalJournal of Vascular Technology
Volume18
Issue number2
StatePublished - Jan 1 1994

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Central Venous Catheters
Upper Extremity
Venous Thrombosis
Color
Pain
Veins
Indwelling Catheters
Physiologic Monitoring
Dyspnea
Blood Vessels
Arm
Catheters
Hand

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Predictability of symptoms of upper extremity deep venous thrombosis in patients with central venous catheters with color duplex imaging",
abstract = "Venous catheter placement, causing trauma to the vein wall, is considered a risk factor for deep venous thrombosis (DVT). Upper extremity DVT, occurring in only 1-3{\%} of all diagnosed DVT, is potentially fatal and may be caused by indwelling venous catheters used for physiologic monitoring. The purpose of this study is to correlate the symptoms, with color duplex diagnosis, of upper extremity DVT in patients with central venous catheters. From January 1 to December 15, 1992, 25 patients with a recent history of central venous catheter placement were referred to the vascular laboratory to rule out upper extremity DVT. DVT was determined by color duplex imaging with attention to flow characteristics and vein compressibility. Of the 25 patients, 48{\%} (12 of 25) were positive for DVT. Eight patients presented with a combination of ipsilateral arm pain and swelling of whom 6 (75{\%}) had DVT. Of the other 17 patients who presented with a single symptom of either pain, swelling, dyspnea, hypoxia, or hand pain, 35{\%} (6 of 17) were positive for DVT. The positive predictive value of using a combination of pain and swelling to predict upper extremity DVT in patients with central venous catheters was 75{\%} with a negative predictive value of 65{\%} (sensitivity = 50{\%}, specificity = 85{\%}, accuracy = 68{\%}). The data from this study suggest that in patients with central venous catheters, (1) a combination of pain and swelling has a high correlation with upper extremity DVT while (2) any one symptom alone has a low correlation with upper extremity DVT diagnosed by color duplex imaging.",
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AU - McGrath, R. S.

AU - Freeman, Michael

AU - Stevens, Scott

AU - Goldman, Mitchell

PY - 1994/1/1

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N2 - Venous catheter placement, causing trauma to the vein wall, is considered a risk factor for deep venous thrombosis (DVT). Upper extremity DVT, occurring in only 1-3% of all diagnosed DVT, is potentially fatal and may be caused by indwelling venous catheters used for physiologic monitoring. The purpose of this study is to correlate the symptoms, with color duplex diagnosis, of upper extremity DVT in patients with central venous catheters. From January 1 to December 15, 1992, 25 patients with a recent history of central venous catheter placement were referred to the vascular laboratory to rule out upper extremity DVT. DVT was determined by color duplex imaging with attention to flow characteristics and vein compressibility. Of the 25 patients, 48% (12 of 25) were positive for DVT. Eight patients presented with a combination of ipsilateral arm pain and swelling of whom 6 (75%) had DVT. Of the other 17 patients who presented with a single symptom of either pain, swelling, dyspnea, hypoxia, or hand pain, 35% (6 of 17) were positive for DVT. The positive predictive value of using a combination of pain and swelling to predict upper extremity DVT in patients with central venous catheters was 75% with a negative predictive value of 65% (sensitivity = 50%, specificity = 85%, accuracy = 68%). The data from this study suggest that in patients with central venous catheters, (1) a combination of pain and swelling has a high correlation with upper extremity DVT while (2) any one symptom alone has a low correlation with upper extremity DVT diagnosed by color duplex imaging.

AB - Venous catheter placement, causing trauma to the vein wall, is considered a risk factor for deep venous thrombosis (DVT). Upper extremity DVT, occurring in only 1-3% of all diagnosed DVT, is potentially fatal and may be caused by indwelling venous catheters used for physiologic monitoring. The purpose of this study is to correlate the symptoms, with color duplex diagnosis, of upper extremity DVT in patients with central venous catheters. From January 1 to December 15, 1992, 25 patients with a recent history of central venous catheter placement were referred to the vascular laboratory to rule out upper extremity DVT. DVT was determined by color duplex imaging with attention to flow characteristics and vein compressibility. Of the 25 patients, 48% (12 of 25) were positive for DVT. Eight patients presented with a combination of ipsilateral arm pain and swelling of whom 6 (75%) had DVT. Of the other 17 patients who presented with a single symptom of either pain, swelling, dyspnea, hypoxia, or hand pain, 35% (6 of 17) were positive for DVT. The positive predictive value of using a combination of pain and swelling to predict upper extremity DVT in patients with central venous catheters was 75% with a negative predictive value of 65% (sensitivity = 50%, specificity = 85%, accuracy = 68%). The data from this study suggest that in patients with central venous catheters, (1) a combination of pain and swelling has a high correlation with upper extremity DVT while (2) any one symptom alone has a low correlation with upper extremity DVT diagnosed by color duplex imaging.

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