Isolated Infrapopliteal Deep Venous Thrombosis

  • Madhuri Gore


Though the gold standard of diagnostic modality and treatment of proximal deep vein thrombosis in leg veins is greatly established, the dilemma about approach to isolated distal deep vein thrombosis (IDDVT) still continues. The main reasons for the lack of clear guidelines are inadequate understanding of natural history of IDDVT, variable incidence reported in different studies, inferior sensitivity of diagnostic techniques and inconsistent outcomes of applied treatment.


  1. 1.
    Palareti G. How I treat isolated distal deep vein thrombosis (IDDVT). by guest on 3 Sep 2017.
  2. 2.
    Galanaud J-P, Sevestre M-A, Genty C, Laroche J-P, Zizka V, Quéré I, Bosson J-L, OPTIMEV SFMV Investigators. Comparison of the clinical history of symptomatic isolated muscular calf vein thrombosis versus deep calf vein thrombosis. J Vasc Surg. 2010;52(4):932–8, 938.e1-2. Epub 2010 Jul 13.CrossRefPubMedGoogle Scholar
  3. 3.
    Palareti G, Schellong S. Isolated distal deep vein thrombosis: what we know and what we are doing. J Thromb Haemost. 2012;10:11–9. Scholar
  4. 4.
    Giannoukas AD, Labropoulos N, Burke P, Katsamouris A, Nicolaides AN. Calf deep venous thrombosis : a review of the literature. Eur J Vasc Endovasc Surg. 1995;10:398–404.CrossRefGoogle Scholar
  5. 5.
    Alhalbouni S, Hingorani A, Shiferson A, Marks N, Ascher E. Infra-popliteal deep venous thrombi and the risk of symptomatic pulmonary embolism in hospitalized patients. Vascular. 2011;19:29.CrossRefGoogle Scholar
  6. 6.
    Galanaud JP, Sevestre MA, Genty C, Kahn SR, Pernod G, Rolland C, Diard A, Dupas S, Jurus C, Diamand JM, Quere I, Bosson JL, OPTIMEV-SFMV Investigators. Incidence and predictors of venous thromboembolism recurrence after a first isolated distal deep vein thrombosis. J Thromb Haemost. 2014;12:436–43. Scholar
  7. 7.
    Cohen AT, Balaratnam S, Fassiadis N. Are isolated distal deep-vein thromboses clinically significant? Therapy. 2008;5(2):151–7. Scholar
  8. 8.
    Gillet J-L, Perrin MR, Allaert FA. Short-term and mid-term outcome of isolated symptomatic muscular calf vein thrombosis. J Vasc Surg. 2007;46:513–9.CrossRefGoogle Scholar
  9. 9.
    Masuda EM, Kistner RL, Musikasinthorn C, Liquido F, Geling O, He Q. The controversy of managing calf vein thrombosis. J Vasc Surg. 2012;55:550–61.CrossRefGoogle Scholar
  10. 10.
    Sule AA, Chin TJ, Handa P, Earnest A. Should symptomatic, isolated distal deep vein thrombosis be treated with anticoagulation? Int J Angiol. 2009;18(2):83–7.CrossRefGoogle Scholar
  11. 11.
    Wells PS, Anderson DR, Bormanis J, et al. Value of assessment of pretest probability of deep-vein thrombosis in clinical management. Lancet. 1997;350(9094):1795–8.CrossRefGoogle Scholar
  12. 12.
    Wells PS, Owen C, Doucette S, Fergusson D, Tran H. Does this patient have deep vein thrombosis? JAMA. 2006;295(2):199–207.CrossRefGoogle Scholar
  13. 13.
  14. 14.
    Robert-Ebadi H, Righini M. Management of distal deep vein thrombosis. Thromb Res. 2017;149:48–55. Scholar
  15. 15.
    Bates SM, Jaeschke R, Stevens SM, et al. Diagnosis of DVT: antithrombotic therapy and prevention of thrombosis, 9th ed. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141:e351S–418S.CrossRefGoogle Scholar
  16. 16.
    Kitchen L, Lawrence M, Speicher M, Frumkin K. Emergency department management of suspected calf-vein deep venous thrombosis: a diagnostic algorithm. West J Emerg Med. 2016;17(4):384–90. Scholar
  17. 17.
    In Clinical Questions by David Wonnacott, March 21, 2017, 3 Comments. Isolated distal DVT – diagnosis and management.
  18. 18.
    Righini M. Is it worth diagnosing and treating distal deep vein thrombosis? No. J Thromb Haemost. 2007;5(s1):55–9. Scholar
  19. 19.
    Singh K, Yakoub D, Giangola P, DeCicca M, Patel CA, Marzouk F, Giangola G. Early follow-up and treatment recommendations for isolated calf deep venous thrombosis. J Vasc Surg. 2012;55:136–40.CrossRefGoogle Scholar
  20. 20.
    Solis MM, Ranval TJ, Nix ML, Eidt JF, Nelson CL, Ferris EJ, Lavender RC, Barnes RW. Is anticoagulation indicated for asymptomatic postoperative calf vein thrombosis? J Vasc Surg. 1992;16(3):414–8; discussion 418-9.CrossRefGoogle Scholar
  21. 21.
    Righini M, Galanaud JP, Guenneguez H, Brisot D, Diard A, Faisse P, Barrellier MT, Hamel-Desnos C, Jurus C, Pichot O, Martin M, Mazzolai L, Choquenet C, Accassat S, Robert-Ebadi H, Carrier M, Le Gal G, Mermilllod B, Laroche JP, Bounameaux H, Perrier A, Kahn SR, Quere I. Anticoagulant therapy for symptomatic calf deep vein thrombosis (CACTUS): a randomised, double-blind, placebo-controlled trial. Lancet Haematol. 2016;3:e556.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Madhuri Gore
    • 1
  1. 1.Consultant SurgeonFormer Professor and Chief of Surgery, LTMG HospitalMumbaiIndia

Personalised recommendations