It has traditionally been thought that upper-extremity deep venous thrombosis (UEDVT) is not clinically relevant when compared with iliofemoral DVT and is less likely to lead to pulmonary thromboembolism. However, recent reports have cast doubt on this assumption, concluding that up to 36% of patients with UEDVT subsequently developed pulmonary thromboembolism. Specifically, the article by Prandoni et al1 concludes that "UEDVT is a serious thrombotic disorder that fully resembles the corresponding disease of the lower extremity," and that patients found to have UEDVT should be medically treated with anticoagulant therapy just as patients with iliofemoral DVT. We do not agree with these conclusions and are concerned that they might represent a major shift in clinical practice based on the results of a study that looked at a small number of extremely heterogeneous patients with upper-extremity thromboembolic disease.
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