{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T21:06:49Z","timestamp":1760044009742,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2016,8,2]]},"abstract":"<jats:p>A healthy female presented with upper extremity (UE) swelling of several days duration. Admission laboratories were normal except for an elevated D-dimer. An UE ultrasound with Doppler revealed a thrombus in the right subclavian vein. A subsequent chest CT angiogram further characterised the subclavian vein thrombus and also identified a pulmonary embolus. A thorough history and laboratory evaluation showed that her only risk factors were long-time contraceptive pills and a recent cycle of ovarian hyperstimulation (OH) 7\u2005weeks prior to presentation. Anticoagulation treatment was started and the patient's remaining outpatient work-up was negative for all other hereditary causes. A complete anatomic work-up showed bilateral thoracic outlet syndrome (TOS). A review of the literature on the occurrence of upper extremity deep venous thrombosis suggests that these usually occur in the presence of a predisposing factor, including catheters, indwelling devices and active malignancies. OH has been shown to precipitate venous thromboembolism events; however, the diagnosis of bilateral TOS as a predisposing risk factor has not been described in a patient who had recently undergone recent OH and in one who was not actively pregnant.<\/jats:p>","DOI":"10.1136\/bcr-2016-216719","type":"journal-article","created":{"date-parts":[[2016,8,16]],"date-time":"2016-08-16T11:56:35Z","timestamp":1471348595000},"page":"bcr2016216719","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Upper extremity deep venous thrombosis and pulmonary embolus after ovarian hyperstimulation"],"prefix":"10.1136","volume":"2016","author":[{"given":"Anne Catherine Miller","family":"Cramer","sequence":"first","affiliation":[{"name":"George Washington University Hospital, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Warszawa","family":"McLean","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care, George Washington University Hospital, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jalil","family":"Ahari","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care, George Washington University Hospital, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,8,16]]},"reference":[{"key":"2025082722114392000_2016.aug16_1.bcr2016216719.1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000142289.94369.D7"},{"key":"2025082722114392000_2016.aug16_1.bcr2016216719.2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1997.00440220061008"},{"key":"2025082722114392000_2016.aug16_1.bcr2016216719.3","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000137123.55051.9B"},{"key":"2025082722114392000_2016.aug16_1.bcr2016216719.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2007.05.023"},{"key":"2025082722114392000_2016.aug16_1.bcr2016216719.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(00)00491-X"},{"key":"2025082722114392000_2016.aug16_1.bcr2016216719.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2006.02026.x"},{"key":"2025082722114392000_2016.aug16_1.bcr2016216719.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.07.1708"},{"key":"2025082722114392000_2016.aug16_1.bcr2016216719.8","doi-asserted-by":"publisher","DOI":"10.1160\/TH12-05-0352"},{"key":"2025082722114392000_2016.aug16_1.bcr2016216719.9","doi-asserted-by":"publisher","DOI":"10.4250\/jcu.2010.18.3.98"},{"key":"2025082722114392000_2016.aug16_1.bcr2016216719.10","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-951458"},{"key":"2025082722114392000_2016.aug16_1.bcr2016216719.11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e8632"},{"key":"2025082722114392000_2016.aug16_1.bcr2016216719.12","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dei235"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2016-216719","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:11:55Z","timestamp":1756357915000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2016-216719"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8,16]]},"references-count":12,"alternative-id":["10.1136\/bcr-2016-216719"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2016-216719","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2016,8,16]]}}}