A Population-Based Study of Incidence, Presentation, Management and Outcome of Primary Thromboembolic Ischemia in the Upper Extremity

  • Jørgen B. VenneslandEmail author
  • Kjetil Søreide
  • Jan Terje Kvaløy
  • Andreas Reite
  • Morten Vetrhus
Original Scientific Report



To investigate the epidemiology of acute upper limb thromboembolism in a well-defined Norwegian population.


This study was a retrospective, single-center, observational population-based cohort study of acute upper limb thromboembolism. The study included all patients from the hospital’s primary catchment area from January 2000 to December 2015. Age- and gender-adjusted incidence rates were calculated using population demographics from Statistics Norway.


A total of 54 patients were identified, of which 49 were included in the analyses: 27 (55%) females (median age 83 years, range 40–96) and 22 (45%) males (median age 70 years, range 42–95) (P = .053). The adjusted incidence rate for the period was 1.6 patients per 100,000 inhabitants per year (95% confidence interval 1.2–2.2) and did not change significantly during the period studied. Atrial fibrillation was detected by electrocardiography in 30 (61%) patients; in this group, 10 patients were on warfarin but only two had an international normalized ratio > 1.9 and the remaining 20 were not anticoagulated. Altogether, 38 (78%) patients underwent surgery, 1 (2%) was treated with thrombolysis, and the remaining patients were treated conservatively; no amputations were performed. Four patients (8%) died within 30 days, and 12 of the surviving 45 patients (27%) had recurrent thromboembolism.


The incidence rate was stable during the study period. Patients with upper limb thromboembolism due to atrial fibrillation were inadequately anticoagulated. One in four patients experienced a recurrent thromboembolic event. Lifelong anticoagulation should be considered in all patients with upper limb thromboembolism.



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Copyright information

© Société Internationale de Chirurgie 2019

Authors and Affiliations

  • Jørgen B. Vennesland
    • 1
    Email author
  • Kjetil Søreide
    • 2
    • 3
    • 4
  • Jan Terje Kvaløy
    • 5
    • 6
  • Andreas Reite
    • 1
  • Morten Vetrhus
    • 1
  1. 1.Department of Surgery, Vascular Surgery UnitStavanger University HospitalStavangerNorway
  2. 2.Department of Gastrointestinal SurgeryStavanger University HospitalStavangerNorway
  3. 3.University of BergenBergenNorway
  4. 4.Clinical MedicineUniversity of BergenBergenNorway
  5. 5.Research DepartmentStavanger University HospitalStavangerNorway
  6. 6.Department of Mathematics and PhysicsUniversity of StavangerStavangerNorway

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