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Feature Article

Calf vein thrombosis and superficial venous thrombosis: advice on management

David Robinson

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Abstract

Venous thrombotic problems are common in clinical practice, and management guidelines for DVT and pulmonary embolism are well established. However, the optimal management of calf vein and superficial venous thrombosis is more controversial.

Key Points

  • Calf vein thrombosis has a low but still significant risk of pulmonary embolism and thrombus extension, and should not be ignored.
  • Superficial venous thrombosis is associated with inflammatory symptoms and has the risk of possible extension of the thrombus to involve the deep vein system.
  • Duplex ultrasound should be used to assess both calf vein and superficial venous thrombosis.
  • Anticoagulation with low molecular weight heparin or fondaparinux is the preferred treatment for calf vein thrombosis and superficial venous thrombosis.
  • Active surveillance is an option for patients with calf vein thrombosis who have a high risk of bleeding, a low risk pattern of disease or less severe symptoms.
  • Topical anti-inflammatory treatments and surveillance is an option for patients with superficial venous thrombosis who have a high risk of bleeding or a very small localised thrombosis.

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