Therapeutic Anticoagulation for Isolated Calf Deep Vein Thrombosis

摘要: Importance Deep vein thrombosis (DVT) isolated to the calf veins (distal popliteal vein) is frequently detected with duplex ultrasonography and may result in proximal or pulmonary embolism (PE). Objective To evaluate whether therapeutic anticoagulation associated a decreased risk for DVT PE after diagnosis of an DVT. Design, Setting, Participants All adult patients ultrasonographic detection from January 1, 2010, December 31, 2013, at Vascular Laboratory University California, Davis, Medical Center were included. Patients already receiving those chronic DVT, contraindication anticoagulation, prior venous thromboembolism within 180 days, suspected time excluded. Data analyzed August 18, 2015, February 14, 2016. Exposures Intention administer anticoagulation. Main Outcomes Measures Proximal days Results From 14 056 lower-extremity studies, we identified 697 excluded 313 these. The remaining 384 available analysis (222 men [57.8%]; 162 women [42.2%]; mean [SD] age, 60 [16] years). involved axial (anterior tibial, posterior peroneal) 243 (63.2%) muscular branch (soleus gastrocnemius) 215 (56.0%). Physicians attempted (63.3%), leaving 141 control participants. occurred 7 controls (5.0%) 4 recipients (1.6%); PE, 6 (4.3%) (1.6%). Therapeutic was (odds ratio [OR], 0.34; 95% CI, 0.14-0.83) but increased bleeding (OR, 4.35; 1.27-14.9), findings that persisted adjustment confounding factors (ORs, 0.33 [95% 0.12-0.87] 4.87 1.37-17.3], respectively) sensitivity analyses. Conclusions Relevance Rates are low reduction these outcomes increase bleeding.