Subtypes/Complications

Definition: a severe form of phlebothrombosis characterized by obstruction of all veins of one extremity, with subsequent restriction of arterial flow; associated with high mortality

Symptoms

• Severe swelling, edema, and pain

• Coldness, cyanosis, and pulselessness

Treatment

• Emergency surgery: venous thrombectomy, fasciotomy

• Fibrinolysis if surgery fails

• Amputation as last resort

Complications: shock, gangrene, acute renal failure (due to rhabdomyolysis)

Definition: acute thrombosis of a brachial, axial, or subclavian vein

Etiology

• Effort-induced thrombosis: triggered by repetitive strenuous activity of the upper extremities (e.g., weight-lifting, operation of a jackhammer)

• Thoracic outlet syndrome

Treatment: anticoagulation, fibrinolysis, surgery (e.g., first rib resection) for thoracic outlet syndrome

Pulmonary embolism: Pulmonary emboli most commonly originate in the proximal deep veins of the lower extremities (e.g., iliac, femoral, or popliteal veins).

Postthrombotic syndrome (chronic venous insufficiency)

Venous gangrene (rare complication)

• The development of ischemic necrosis of a distal extremity despite palpable or doppler pulses, occurring as a complication of deep vein thrombosis

• Often associated with the use of warfarin in patients with acquired hypercoagulability (e.g., in malignancy, heparin-induced thrombocytopenia, antiphospholipid syndrome).