Background

A blood clot that forms in the deep blood vessels of the arms, blocking the passage of blood, is referred to as an acute upper extremity deep vein thrombosis. An acute upper extremity deep vein thrombosis currently affects 4 to 10 per 100,000 people in the general population. One of the most serious complications of an upper extremity deep vein thrombosis is a pulmonary embolism, which is a blockage of one of the major blood vessels in the lung. This can be a life-threatening condition. Post-thrombotic syndrome, in which the blood clot causes permanent swelling, skin colour changes, sores or ulcers, and decreased function of the affected limb, is another serious complication that can impact a person’s quality of life.

Thrombolysis aims to break down the blood clot with the use of drugs infused directly into a blood vessel. A previous Cochrane Review looked at the beneficial and harmful effects of thrombolysis for the treatment of acute deep vein thrombosis of the lower extremities (e.g. the legs). While thrombolysis was found to lower the risk of post-thrombotic syndrome, it had no effect on the risk of death, risk of a blood clot travelling to the lungs or brain, (where it can cause a stroke), or the risk of bleeding inside the skull. In this present review, we attempted to assess the benefits and harms of thrombolysis for the treatment of acute upper extremity deep vein thrombosis.

Study characteristics and key results

We found no randomised clinical trials (search current until March 2017) that met the inclusion criteria of our review. Hence, the benefits and harms of thrombolysis for acute upper extremity deep vein thrombosis remain unknown.

Conclusion

Large trials using proper methods and reporting on patient-relevant outcomes are needed.