Deep Vein Thrombosis Upper Extremity
Vascular Access for a patient with Deep Vein Thrombosis (DVT) in the upper extremity requires the Clinician to evaluate additional facts and data. This page describes important factors for the Vascular Access Clinician to consider.
Deep Vein Thrombosis (DVT)
Deep Vein Thrombosis (DVT) occurs when a blood clot forms in one or more veins located deep inside the body. While DVT occurs most often in the legs causing swelling, pain, and discoloration, DVT can also occur in the upper arms. Blood clots in the veins are cause for concern as they can be very serious. If a blood clot breaks free, it can travel through the veins in the body and eventually get lodged, blocking blood flow. For example, it can cause a serious condition called a pulmonary embolism, which is a blocking of the lungs.
DVT and Blood Clots can occur in Legs and Upper Arms
Catheter to Vein Ratio must be less than 45% to mitigate the risk of DVT
Vascular Access – Deep Vein Thrombosis (DVT)
Vascular Access through a PICC or Midline can cause Deep Vein Thrombosis (DVT) in the upper arm as a result of the catheter taking up and occupying space in the vein. Vascular Wellness measures every vein to make sure the catheter to vein ratio is less than 45% to help mitigate this risk. Reasons for DVT are not known and this is not a typical outcome; however, when it does happen, the PICC or Midline should not be removed. American College of Chest Physicians, (CHEST) Guidelines specify that in regard to DVT Management, the catheter stays in place as removing it could cause the clot moving to another location in the body or increasing in size. Vascular Wellness follows the CHEST Guidelines which also recommends to anti-coagulate the patient to eliminate the blood clot. Most patients respond well to this therapy and can continue to use their PICC or Midline for the entire course of therapy.
Vascular Access – Existing DVT Patient
Vascular Access for an existing DVT patient requires additional skill, care, and consideration. In this situation, Vascular Access should not be done by the PICC and Midline procedure. Small Bore Internal Jugular Central Venous Catheter Line is the solution, with a Small Bore Femoral Central Venous Line as an additional alternative. Unlike another PICC or Midline which has the risk of the DVT increasing in size, these central catheter lines help mitigate the possibility for additional clots or the clot breaking free and causing damage
Small Bore Internal Jugular Line or Femoral Line avoids the risk of the DVT increasing in size, additional blood clots, or existing clots breaking free.
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