top of page

Axillary Vein Thrombosis


These cases are seen through the DVT clinic has a useful section, summarised below


Risk factors 

  • In situ central venous catheter

  • Venous compression in thoracic outlet syndrome

  • Active malignancy

  • Oral contraceptives, pregnancy

  • Congenital thrombophilia, acquired coagulation defects

  • Diabetes mellitus

  • Obesity, smoking habit or intense sports activity




  • Symptoms can be intermittent, or can develop during a period of up to one week

  • Patients tend to present with discomfort and swelling, associated with discolouration of the hand.

  • 7-20% of cases may lead to pulmonary embolism (PE) with features of pleuritic chest pain, breathlessness and haemoptysis


  • Physical examination may show low-grade fever due to thrombus formation. Higher fevers are seen with septic thrombophlebitis or in patients with associated malignancy 

  • Oedema of the arm and hand - measure the biceps/forearm diameter at a fixed distance from an anatomical landmark.

  • Mild-to-moderate cyanosis of the hand.

  • Dilated superficial collateral veins may be seen over the chest and upper arm - may be the only indicator in central venous cannulation.

  • Fullness in the supraclavicular fossa and even a palpable cord of thrombosed vein.

  • Jugular vein may be distended.


Differential diagnosis

  • Superficial phlebitis

  • Cellulitis

  • Severe superficial bruising

  • Muscular tear

  • Intramuscular haemorrhage

  • Lymphoedema

  • Occult fracture

  • Superior vena cava obstruction

  • Lymphangitis

  • Localised allergy

  • Gas gangrene



bottom of page