Upper Extremity Deep Vein Thrombosis

Understanding Thrombosis

What is Upper Extremity Deep Vein Thrombosis?

Upper extremity deep vein thrombosis (DVT) occurs when blood clots form in the deep veins of the arms, shoulders and upper chest rather than the legs. This arm DVT typically develops in the axillary vein, subclavian vein or basilic vein.

Upper arm blood clots are less common than lower extremity DVT. The condition most frequently develops in patients with central venous catheters, including intravenous lines, PICC lines (peripherally inserted central catheters) and Portacath devices.

Learn more about upper-extremity DVT
What is upper-extremity DVT

Signs and Symptoms

Common signs of upper-extremity deep vein thrombosis include:

  • Sudden pain
  • Warmth
  • Discoloration of the arm
  • Swelling in the arm

Unlike leg DVT, upper extremity clots may cause neck pain and shoulder discomfort.

Patients should seek immediate medical attention if they experience sudden arm swelling or severe pain.

Risk Factors

Medical devices and procedures significantly increase the risk of developing upper extremity blood clots.

Patients with cancer who require long-term IV access through central lines face the highest risk.

Other contributing factors include thoracic outlet syndrome, repetitive arm motions and certain autoimmune conditions.

Causes

Most upper extremity DVTs occur due to pressure or blockage or damage to the veins as they leave the arm or shoulder. Additional specific causes can include:

  • Thoracic outlet syndrome – when the upper ribs press up against the veins or nerves.
  • A history of injury or heavy exercise to the upper body, also known as “effort induced thrombosis.” This can develop after vigorous, repetitive activity with repetitive arm movements, such as swimmers, weight lifters, athletes who throw shot put, javelin, etc. or people whose job entails repetitive arm movements.
Learn more about upper-extremity DVT from the ISTH

Research on Upper-Extremity DVT from the International Society on Thrombosis and Haemostasis (ISTH)

“The upper extremity postthrombotic syndrome score: an international Delphi consensus study to determine the score’s functional disability component“ – Res Pract Thromb Haemost. 2023. doi: 10.1016/j.rpth.2023.100051 

“Postthrombotic syndrome following upper extremity deep vein thrombosis in children“ – Res Pract Thromb Haemost. 2023. doi: 10.1016/j.rpth.2023.100094 

“A Single Center Retrospective Cohort Study Comparing Different Anticoagulants for the Treatment of Catheter-Related Thrombosis of the Upper Extremities in Women With Gynecologic and Breast Cancer“ – J Thromb Haemost. 2024. doi: 10.1016/j.jtha.2023.11.017 

“Functional impact of pediatric postthrombotic syndrome“ – J Thromb Haemost. 2023. doi: 10.1016/j.jtha.2023.01.004 

“Post-thrombotic syndrome after upper extremity deep vein thrombosis: An international Delphi consensus study“ – J Thromb Haemost. 2022. doi: 10.1111/jth.15767 []

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