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ARTICLE |

Calf Deep Venous Thrombosis:  A Wolf in Sheep's Clothing?

John T. Philbrick, MD; Daniel M. Becker, MD, MPH
Arch Intern Med. 1988;148(10):2131-2138. doi:10.1001/archinte.1988.00380100029007.
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• To determine the natural history of calf deep venous thrombosis (C-DVT), an analytic review of the 20 relevant English-language papers published since 1942 was performed. Remarkably little methodologically sound research on this subject was found. However, available evidence suggests that C-DVT propagates to the thigh in up to 20% of cases and that propagation invariably occurs before embolization. No fatal emboli were reported in patients presenting with isolated C-DVT. Traditional anticoagulation treatment with heparin sodium and warfarin sodium of symptomatic patients with C-DVT appears to prevent extension, embolization, and early recurrence. There is no convincing evidence that C-DVT leads to chronic venous insufficiency or whether the risks of anticoagulation exceed the risks of no treatment. As an option to anticoagulation, physicians may choose to follow patients with C-DVT with serial impedance plethysmography, treating only if there is evidence of proximal extension.

(Arch Intern Med 1988;148:2131-2138)

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