Journal du sang et de la lymphe

Upper Limb DVT in an Oncological Patient with a PICC Treated with Edoxaban: A Case Report

Abstract

Pierpaolo Di Micco, Gianluca Di Micco and Corrado Lodigiani

Upper extremities deep venous thrombosis (UEDVT) is less frequent than lower limb DVT but the incidence of UEDVT may be increased in patients affected by malignancies and bearing central venous catheters (CVC) or other devices as peripherally inserted central catheters (PICC). The standard of care for the treatment of cancer-related venous thromboembolism has been low molecular weight heparin (LMWH) for several years. But treatment with direct oral anticoagulants (DOACs) may represent an alternative to LMWH in patients with cancer related VTE. In the present article, we report a case of a 49 year old man with colorectal cancer in treatment with chemotherapy who presented DVT of the upper left limb with involvement of subclavian-axillar venous axis. Patient was treated with edoxaban 60 mg following a few days of LMWH (i.e., 100 u/kg twice daily). After three months, a vascular ultrasound scan showed the disappearance of DVT with a full recanalization of the vessel.