Abstract / Summary
Arterial and venous thrombosis are traditionally regarded as pathophysiologically distinct processes, yet procedure-related thrombosis following vascular access offers a controlled setting in which an identical iatrogenic trigger (endothelial injury) precipitates thrombosis in different vascular beds. This study aimed to directly compare procedure-related radial artery thrombosis (RAT) and upper extremity superficial venous thrombophlebitis (UESVT) in terms of demographics, hematological profile, and clinical outcomes, to determine whether they represent the same disease process or distinct clinical entities. This retrospective, two-center cohort study was conducted at the Emergency Medicine Departments of Ankara Bilkent City Hospital and Ankara Etlik City Hospital. Two cohorts were compared: An Arterial Group ( n = 59) with radial artery thrombosis after arterial access, and a Venous Group ( n = 78) with superficial upper extremity venous thrombosis after peripheral intravenous catheterization, both confirmed by color Doppler ultrasonography. Demographics, comorbidities, complete blood count parameters, seven derived hematological ratios, treatments, and outcomes were compared using the Mann-Whitney U test, χ²/Fisher’s exact test, correlation analysis, ROC-AUC, and multivariable logistic regression. A total of 137 patients were analyzed. Arterial patients were older (median 53 vs. 43.5 years, p = 0.002) and had markedly higher rates of coronary artery disease (81.4% vs. 15.6%, p < 0.001) and diabetes mellitus (35.6% vs. 15.4%, p = 0.011). Venous patients showed higher neutrophil counts and neutrophil-to-lymphocyte ratio (NLR 2.81 vs. 2.12, p = 0.002), whereas arterial patients had higher lymphocyte and platelet counts, along with higher lymphocyte-to-monocyte ratio, platelet-to-leukocyte ratio, and platelet-to-PDW ratio (all p < 0.05). Total vascular occlusion occurred in 28.8% of arterial cases versus 1.3% of venous cases ( p < 0.001), while total recovery was achieved in 66.1% versus 97.4% ( p < 0.001); no mortality or limb loss occurred in either group. Multivariable logistic regression identified coronary artery disease as the strongest independent predictor of arterial group membership (OR 46.77, 95% CI 11.11–196.83, p < 0.001), with the model discriminating the two groups with high accuracy (AUC 0.897). Despite arising from an identical iatrogenic trigger, procedure-related radial artery thrombosis and upper extremity superficial venous thrombophlebitis are hematologically and clinically distinct conditions rather than variants of a single disease process. UESVT typically follows a benign, neutrophil-driven inflammatory course with near-universal recovery, whereas RAT occurs in older patients with substantial cardiovascular comorbidity, exhibits a platelet-dominant hematological signature, and carries a substantially higher risk of permanent vascular occlusion, warranting prompt diagnosis and aggressive, individualized antithrombotic management. Not applicable