Deep vein thrombosis: calf: calf-to-thigh propagation often occurred.

Clinical bottom line (level 4)

  1. There was a significant rate of calf-to-thigh propagation, recurrent deep vein thrombosis and chronic venous insufficiency in patients with calf DVT.
Fulbrick and Becker: Archives of Internal Medicine 1988; 148: 2131-2138
Expires December 2003

The study

Systematic review of all of
  • Patients: established diagnosis of calf deep vein thrombosis or thrombophlebitis
  • Outcome: prevalence of calf-to-thigh propagation, recurrent deep vein trombosis, chronic venous insufficiency


    • Articles found in English using MEDLINE, 1966 to 1987 (search terms: ) and Index Medicus, Current Contents and bibliographies were searched (1942 to 1987)

    Selection criteria: as above
    Appraisal criteria: selected using set criteria by independent reviewers
    Articles excluded if:

    15 case studies, 1 cohort and 6 randomised controlled trials were included

    The evidence

    • Anticoagulation:
      • calf-to-thigh propagation- 10%
      • recurrent deep vein thrombosis- 4% to 9%
      • chronic venous insufficiency- 21% to 79%
    • No anticoagulation:
      • calf-to-thigh propagation- 6% to 23% of cases

    Comments

    1. Many studies had methodological flaws especially failure to describe how cohorts were assembled, and no objective diagnosis of pulmonary embolism or deep vein thrombosis.
    2. Recurrent deep vein thrombosis rate from calf DVT was similar to the rate from all DVT.

    Citation

    1. Fulbrick JT, and Becker DL: Calf deep venous thrombosis: a wolf in sheep's clothing?. Archives of Internal Medicine 1988; 148: 2131-2138
    Contributor: Chris Ball and Clare Wotton, June 2000
    Reviewer:

    Clinical Question.
    Patient calf DVT or thrombophlebitis
    Intervention or Exposure prevalence
    Outcome calf-thigh propagation, recurrent DVT