Should Patients with Isolated DVT of the Calf Be Anticoagulated?

Despite increased bleeding risks, therapeutic anticoagulation for isolated calf deep venous thrombosis might be warranted, but we need randomized, controlled trials.

Approaches to managing acute isolated calf deep venous thrombosis (DVT) range widely and include no treatment, repeat imaging, and therapeutic anticoagulation of varying durations. In a single-center, observational study, researchers evaluated whether therapeutic anticoagulation after a diagnosis of isolated calf DVT decreases the risk for a proximal DVT or pulmonary embolism (PE).

Of the 384 patients with acute isolated calf DVT (mean age, 60; 58% men), 243 were intended for therapeutic anticoagulation and 141 were not (controls). Therapeutic anticoagulation consisted of warfarin in 75%, a low-molecular-weight heparin in 18%, heparin infusion in 6%, and a direct-acting oral anticoagulant in 1%.

Overall, a proximal DVT or PE occurred in 13 co…

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Should Patients with Isolated DVT of the Calf Be Anticoagulated?

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Reviewing Author