A reappraisal of thrombolysis in primary deep vein thrombosis of upper extremities: Be conservative

Thrombolysis is increasingly used in academic centres as first line management in patients who present within the first two weeks of the index event and upper extremity primary deep vein thrombosis (UEDVT). The purpose of this report is to establish whether this approach is evidence based. A review of the recent literature showed that thrombolysis should be offered to a small number of young and active patients with severe acute symptoms, who are very concerned about developing post-thrombotic syndrome. The majority of the patients can still be treated with anticoagulation alone as there is only limited evidence on the merits of thrombolysis for the initial management of patients with UEDVT.