Comparison of the clinical history of symptomatic isolated muscular calf vein thrombosis versus deep calf vein thrombosis

Background Half of all lower limb deep vein thromboses (DVT) are distal DVT that are equally distributed between muscular calf vein thromboses (MCVT) and deep calf vein thromboses (DCVT). Despite their high prevalence, MCVT and DCVT have never been compared so far, which prevents possible modulation...

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Bibliographic Details
Published in:Journal of vascular surgery 2010-10, Vol.52 (4), p.932-938.e2
Main Authors: Galanaud, Jean-Philippe, MD, Sevestre, Marie-Antoinette, MD, Genty, Céline, MS, Laroche, Jean-Pierre, MD, Zizka, Violaine, MD, Quéré, Isabelle, MD, PhD, Bosson, Jean-Luc, MD, PhD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Anticoagulants - therapeutic use
Biological and medical sciences
Blood. Blood coagulation. Reticuloendothelial system
Chi-Square Distribution
Edema - etiology
Female
France
Humans
Leg - blood supply
Logistic Models
Male
Medical sciences
Middle Aged
Odds Ratio
Pain - etiology
Pharmacology. Drug treatments
Proportional Hazards Models
Prospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Time Factors
Treatment Outcome
Ultrasonography, Doppler
Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
Venous Thrombosis - complications
Venous Thrombosis - diagnostic imaging
Venous Thrombosis - drug therapy
Venous Thrombosis - mortality
Young Adult
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Summary:Background Half of all lower limb deep vein thromboses (DVT) are distal DVT that are equally distributed between muscular calf vein thromboses (MCVT) and deep calf vein thromboses (DCVT). Despite their high prevalence, MCVT and DCVT have never been compared so far, which prevents possible modulation of distal DVT management according to the kind of distal DVT (MCVT or DCVT). Methods Using data from the French, multicenter, prospective observational OPTimisation de l'Interrogatoire dans l'évaluation du risque throMbo-Embolique Veineux (OPTIMEV) study, we compared the clinical presentation and risk factors of 268 symptomatic isolated DCVT and 457 symptomatic isolated MCVT and the 3-month outcomes of the 222 DCVT and 390 MCVT that were followed-up. Results During the entire follow-up, 86.5% of DCVT patients and 76.7% of MCVT patients were treated with anticoagulant drugs ( P = .003). MCVT was significantly more associated with localized pain than DCVT (30.4% vs 22.4%, P = .02) and less associated with swelling (47.9% vs 62.7%, P < .001). MCVT and DCVT patients exhibited the same risk factors profile, except that recent surgery was slightly more associated with DCVT (odds ratio, 1.70%; confidence interval, 1.06-2.75), and had equivalent comorbidities as evaluated by the Charlson index. At 3 months, no statistically significant difference was noted between MCVT and DCVT in death (3.8% vs 4.1%), venous thromboembolism recurrence (1.5% vs 1.4%), and major bleeding (0% vs 0.5%). Conclusion Isolated symptomatic MCVT and DCVT exhibit different clinical symptoms at presentation but affect the same patient population. Under anticoagulant treatment and in the short-term, isolated distal DVT constitutes a homogeneous entity. Therapeutic trials are needed to determine a consensual mode of care of MCVT and DCVT.
ISSN:0741-5214
1097-6809
DOI:10.1016/j.jvs.2010.05.019