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Blood, 15 December 2008, Vol. 112, No. 13, pp. 4818-4823.
Prepublished online as a Blood First Edition Paper on September 19, 2008; DOI 10.1182/blood-2008-07-165969.
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Submitted July 24, 2008
Accepted August 22, 2008
How I treat rare venous thromboses
Ida Martinelli, Massimo Franchini, and Pier Mannuccio Mannucci*
A. Bianchi Bonomi Hemophilia and Thrombosis Center, IRCCS Maggiore Hospital and University of Milan, Milan, Italy
Immunohematology and Transfusion Center, Department of Pathology and Laboratory Medicine, University of Parma, Parma, Italy
* Corresponding author; email: piermannuccio.mannucci{at}unimi.it.
Venous thromboembolism may involve venous sites other than the lower limbs, such as cerebral, splanchnic and upper limb veins. Although uncommon, these thromboses may be clinically severe and challenging for caregivers. In this review, the main pathogenic, clinical and therapeutic features of thromboses in rare venous sites are discussed. Even though there was a lot of recent progress in understanding the mechanistic role of inherited and acquired thrombophilia and of the interactions between different risk factors, the optimal management of these patients is still unsettled, being currently based on the consensus of experts due to the lack of randomized trials. The implementation of large interdisciplinary registries is a necessary weapon to optimize the treatment of rare venous diseases.

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