The calf vein thrombosis

The distal vein thrombosis is a special disease poorly studied and actually without consensus on the diagnostic evaluation and on the necessary treatment. Sometimes this disease has a good prognosis, but it can extend to proximal veins and it can progress to pulmonary embolism, especially in its bilateral presentation. The main diagnostic test is color duplex Doppler evaluation with compression test, mostly if in expert hands. Compression ultrasound sonography (CUS) has sensibility ranging between 88% and 95% compared to phlebography. Serial ultrasound has two objectives: the first is the diagnosis of distal thrombosis, the second is the evaluation of thrombosis progression to proximal vein. The natural history of this disease is poorly documented and there is no consensus on the necessity of screening and treating patients presented with isolated distal DVT. Some authors use oral anticoagulants; others prefer serial echo-color-Doppler before starting therapy. Recent clinical evidences suggest the use of low weight heparin.