From the Research
A follow-up ultrasound is generally recommended for right cephalic vein thrombosis, though the timing depends on clinical circumstances. Initially, patients should receive appropriate anticoagulation therapy, typically with low molecular weight heparin (such as enoxaparin 1mg/kg twice daily) or direct oral anticoagulants (such as rivaroxaban 15mg twice daily for 21 days, then 20mg daily). The purpose of follow-up imaging is to:
- Evaluate thrombus resolution
- Detect any extension of the thrombus
- Guide decisions about the duration of anticoagulation therapy Upper extremity thromboses like cephalic vein thrombosis generally have a better prognosis than lower extremity thromboses, but monitoring is still important to prevent complications such as pulmonary embolism or post-thrombotic syndrome 1. A follow-up ultrasound should be performed after 3-6 months of anticoagulation therapy to assess for resolution of the thrombus, which helps determine whether anticoagulation can be discontinued 2. Earlier follow-up imaging may be warranted if symptoms worsen or fail to improve. The use of ultrasound in detecting venous thromboembolism has been well studied, and it is a reliable and efficient method for diagnosing and monitoring thrombosis 3. High-resolution real-time ultrasonography is a useful noninvasive technique for the diagnosis and follow-up of therapy in thrombosis of the jugular and subclavian veins, and it can be applied to cephalic vein thrombosis as well 4.