Why the study?
What is the anatomical distribution and origin of deep vein thrombi in patients with suspected DVT or PE?
What is the anatomical distribution and origin of deep vein thrombi in patients with suspected DVT or PE?
The vast majority (92%) of lower limb deep vein thrombi involve the calf veins, suggesting that most DVT originates in the calf before propagating proximally.
Answers are grounded in this paper and cite their sources.
Supports calf-origin hypothesis for most DVT; hypothesis-generating for imaging protocols pending prospective validation.
A series of 952 patients was examined by ascending venography; 812 with clinically diagnosed deep vein thrombosis (DVT) (group 1) and 140 with clinical features suggestive of pulmonary embolism (group 2). Thrombus was demonstrated in 401 (49.4 per cent) of group 1 and in 74 (53 per cent) of group 2 patients. A total of 535 limbs contained thrombus. In 493 (92 per cent) thrombus was present in the calf with either no further clot, or clot in continuity with that in more proximal veins. In the remaining 42 legs (8 per cent) thrombus either originated from multiple discontinuous sites in the legs and pelvis, or in proximal major veins without concomitant calf involvement. The clinical implications of these findings are discussed.
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Stamatakis et al. (1978) studied this question.
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