[Sonographic diagnosis of thrombosis of the calf muscle veins and the risk of pulmonary embolism]

A Hollerweger, P Macheiner, T Rettenbacher, N Gritzmann
Ultraschall in der Medizin 2000, 21 (2): 66-72

AIM: To determine the frequency of deep vein thrombosis in the veins of the calf muscles. The risk of embolism in relation to the localisation of thrombosis was also evaluated.

METHOD: 357 consecutive patients submitted for colour Doppler sonography of the lower extremities were prospectively examined for deep vein thrombosis (DVT). Both axial and muscular calf veins were investigated. 184 of these patients underwent additional investigation for pulmonary embolism.

RESULTS: Diagnosis of DVT was made by means of colour Doppler sonography in 179 patients. Soleal veins (n = 88), peroneal veins (n = 84), the popliteal vein (n = 69), and the superficial femoral vein (n = 53) were the most common sites of thrombosis. Thrombosis of the gastrocnemial veins (n = 49) occurred less frequently. 85 patients (47% of all patients having DVT) showed isolated calf vein thrombosis, in 45 patients (25%) the gastrocnemial and/or soleal veins were the only site of thrombosis. 60% of patients with symptomatic DVT also had pulmonary embolism. The embolic frequency for isolated calf vein thrombosis and muscular calf vein thrombosis was 48% and 50%, respectively.

CONCLUSION: The veins of the calf muscles are a common site of acute DVT and a source of pulmonary embolism. They should always be investigated in patients with suspected DVT of the calf, and in patients with pulmonary embolism.

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