Calf vein thrombosis
In medicine, calf vein thrombosis is deep venous thrombosis (DVT) of the infrapopliteal calf veins.[1] [2] These veins are also called distal calf veins. The trifurcation of the popliteal vein is about 10 cm distal from the mid-patella.[3] The distal veins are the posterior tibial vein, anterior tibial vein, and peroneal vein. Thromboses occur more often in the peroneal and posterior tibial veins than the anterior tibial veins.[1]
Distal DVTs are more common than proximal DVTs in studies using venography[2] but not in studies using ultrasonography[4]. Many distal DVTs are asymptomatic.[5]
Diagnosis
The d-dimer test may not reliably detect thromboses of the calf vein with sensitivity of about 65%.[2]
Comprehensive duplex ultrasonography of the whole leg may adequately indicate patients at low risk of short term complications over three months.[4] Simplified compression ultrasonography limited to the trifurcation of the popliteal vein may need repeating in 5 days.[3]
Treatment
Treatment and follow-up options have been reviewed.[6]
For patients with symptomatic calf-vein thrombosis, compression stockings along with anticoagulation may prevent recurrences.[7]
Prognosis
While unusual, case reports exist of pulmonary embolism from calf vein thrombosis.[8]
References
- ↑ 1.0 1.1 Mattos MA, Melendres G, Sumner DS, et al (November 1996). "Prevalence and distribution of calf vein thrombosis in patients with symptomatic deep venous thrombosis: a color-flow duplex study". J. Vasc. Surg. 24 (5): 738–44. PMID 8918317. [e]
Cite error: Invalid
<ref>tag; name "pmid8918317" defined multiple times with different content - ↑ 2.0 2.1 2.2 Jennersjö CM, Fagerberg IH, Karlander SG, Lindahl TL (October 2005). "Normal D-dimer concentration is a common finding in symptomatic outpatients with distal deep vein thrombosis". Blood Coagul. Fibrinolysis 16 (7): 517–23. PMID 16175012. [e]
Cite error: Invalid
<ref>tag; name "pmid16175012" defined multiple times with different content - ↑ 3.0 3.1 Birdwell BG, Raskob GE, Whitsett TL, et al (January 1998). "The clinical validity of normal compression ultrasonography in outpatients suspected of having deep venous thrombosis". Ann. Intern. Med. 128 (1): 1–7. PMID 9424975. [e]
- ↑ 4.0 4.1 Stevens SM, Elliott CG, Chan KJ, Egger MJ, Ahmed KM (June 2004). "Withholding anticoagulation after a negative result on duplex ultrasonography for suspected symptomatic deep venous thrombosis". Ann. Intern. Med. 140 (12): 985–91. PMID 15197015. [e]
- ↑ Kakkar VV, Howe CT, Flanc C, Clarke MB (August 1969). "Natural history of postoperative deep-vein thrombosis". Lancet 2 (7614): 230–2. PMID 4184105. [e]
- ↑ Masuda EM, Kistner RL, Musikasinthorn C, Liquido F, Geling O, He Q (2012). "The controversy of managing calf vein thrombosis.". J Vasc Surg 55 (2): 550-61. DOI:10.1016/j.jvs.2011.05.092. PMID 22032881. Research Blogging.
- ↑ Lagerstedt CI, Olsson CG, Fagher BO, Oqvist BW, Albrechtsson U (September 1985). "Need for long-term anticoagulant treatment in symptomatic calf-vein thrombosis". Lancet 2 (8454): 515–8. PMID 2863541. [e]
- ↑ Loudon JR (October 1976). "Fatal embolism from calf-vein thrombosis". Lancet 2 (7988): 742–3. PMID 61423. [e]