Calf vein thrombosis

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The popliteal vein formed by the union of the peroneal veins and the anterior and posterior tibial veins.

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. 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]
  2. 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]
  3. 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. 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]
  5. 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]
  6. 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.
  7. 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]
  8. Loudon JR (October 1976). "Fatal embolism from calf-vein thrombosis". Lancet 2 (7988): 742–3. PMID 61423[e]