The prevalence of isolated calf deep vein thrombosis in patients with pulmonary embolism

Aim. Due to discordant results, the risk of isolated calf deep vein thrombosis (DVT) -associated pulmonary embolism (PE) is not well established. This study aimed to detect the prevalence of isolated calf DVT in patients with PE, discussing the importance of isolated calf DVT. Methods. We retrospectively reviewed all the inpatients that were both diagnosed PE and DVT between November 2002 and February 2010 in our hospital, analyzed the prevalence of isolated calf DVT and the relevance details. Results. Among all the 63 patients who were diagnosed both PE and DVT, isolated calf DVT was detected in 23 limbs in 16 patients (16/63=25.4%). Soleal vein was the most frequently involved, with 14 limbs. Ten of the patients had low risk PE, 3 had submassive PE and 3 had massive PE. In the 6 patient who had submassive and massive PE, 4 had bilateral leg calf DVT and all 6 were multiple calf vein involvement. Conclusion. Our results reflected the prevalence of PE at presentation, which was high and included severe cases. Though, as reported, PE during surveillance was the most precisely way to reflect PE in isolated calf DVT, but such a risk of PE at presentation should not just be ignored and its importance still needs to be discussed. Well-designed and adequately powered studies are needed to give strong evidence to recognize the real risk of isolated calf DVT, either at presentation or at surveillance, to distinguish the one with high risk and determine appropriate way to treat it.