Brachial vein is the vein in upper arm. It is a deep vein and accompanies the brachial artery. The beginning point of brachial vein is elbow and it joins upwards in the axillary vein. Thrombosis of vein is formation of clot in deep vein. Brachial vein thrombosis is one of the problems grouped under wider disorder called thoracic outlet syndrome.
Thoracic outlet is a place between the clavicle (collar bone) and the first rib. Blood vessels passing through this area can get compressed giving rise to numbness in fingers, pain in upper arm, neck and shoulder.
Previously considered to be a rare phenomenon, the incidence of brachial vein thrombosis has begun to rise in few decades. This has occurred due to increase in the use of central venous catheters. They are valuable in chemotherapy, dialysis, and giving parenteral nutrition in a serious patient. The only problem with this catheter is when they are kept for a long time; the endothelium lining of the veins may get irritated and inflamed causing thrombosis.
Besides, people who lift heavy objects or weight lifters, wrestlers, rowers are at a risk of deep vein thrombosis of upper arm. Repeated arm motion is the cause in such people. The other reason as mentioned earlier is compression of first rib in thoracic outlet.
Brachial Vein Thrombosis Symptoms
- Edema of the hand and upper arm is a common manifestation of brachial vein thrombosis. The affected arm is painful and tender to touch. The pain radiates to forearm and fingers.
- The pain is also felt in shoulder and neck. In more severe cases where the affliction goes beyond the localized area into the great vein, patient may complain of swelling of face, fullness in head, vertigo or breathing difficulty. The hand and arm becomes atrophied.
- Patient may not be able to move his hands and arm upwards. He may suffer from intense pain.
- Fever is another common issue with any deep vein thrombosis and same is with brachial vein thrombosis. In septic throboplebitis, the fever is markedly high. With fever, there is fast pulse rate. Pain in fingers may be felt.
Treatment Of Brachial Vein Thrombosis
- Considering the morbid nature of brachial vein thrombosis, an effective and early treatment is valuable. Early medication helps to reduce the inflammatory and thrombotic response. The doctor may prescribe anti inflammatory, pain reliever and muscle relaxant medications as a primary line of treatment.
- Patient should avoid lifting heavy objects as well as avoid activities which require repeated physical movements of the shoulder and hand. He should avoid carrying anything of his shoulders such as heavy hand bag. He should try to reduce weight if he is obese since excessive body weight may aggravate the condition.
- Physical therapy and relaxation techniques are valuable to open the compressed thoracic space which is responsible for pressing the brachial vein. Once the pressure on veins is relieved, the symptoms subside. Exercise also increase the range of motion and strengthens the arm muscles.
- Relaxation techniques which include yoga help to reduce the tension and stress on shoulder muscles.
If all the above therapies do not give relief to the patient, the physician may opt for surgery. It is the last option when the symptoms are at its extreme and the damage is significant.
During surgery the surgeon relieves the compression over the blood vessels. In some cases, a portion of first rib is removed that is compressing the brachial vein.