Ohgi S, Tachibana M, Ikebuchi M, Kanaoka Y, Maeda T, Mori T
Second Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan.
Angiology. 1998 Sep;49(9):759-64. doi: 10.1177/000331979804901008.
This study investigated the features of calf deep vein thrombosis (DVT) as a pulmonary embolic source. Fifty-eight lower limbs in 29 patients who were suspected of having DVT distal to the popliteal vein were screened by ultrasonography. Then, ascending venography was performed to confirm the diagnosis. Pulmonary embolism (PE) was diagnosed in suspected patients by use of pulmonary perfusion scanning or pulmonary angiography. Venography revealed calf DVT in 33 limbs in 28 patients. Of 28 patients, six had symptomatic PE. Thrombosis was found in the muscle veins in 18 limbs, the trunk veins in 11, and both veins in four. Isolated single vein thrombosis was found in the soleal vein in 14 limbs (42%), the posterior tibial vein in eight, the peroneal vein in two, and the gastrocnemius vein in two. The overall percentage of soleal vein thrombi was 61%. All six patients with symptomatic PE had isolated soleal vein thromboses. Calf DVT was a pulmonary embolic source when isolated thrombosis of the large soleal vein was more than 7 mm in diameter. Soleal veins were the most frequent and important location of calf DVT, suggesting that these were an occasional embolic source of critical PE.
本研究调查了作为肺栓塞来源的小腿深静脉血栓形成（DVT）的特征。通过超声检查对29例疑似腘静脉远端DVT患者的58条下肢进行筛查。然后，进行上行静脉造影以确诊。通过肺灌注扫描或肺血管造影对疑似患者诊断肺栓塞（PE）。静脉造影显示28例患者的33条肢体存在小腿DVT。在28例患者中，6例有症状性PE。18条肢体的肌肉静脉、11条主干静脉和4条静脉均发现血栓形成。14条肢体（42%）的比目鱼肌静脉、8条胫后静脉、2条腓静脉和2条腓肠肌静脉发现孤立的单静脉血栓形成。比目鱼肌静脉血栓形成的总体百分比为61%。所有6例有症状性PE的患者均有孤立的比目鱼肌静脉血栓形成。当比目鱼肌大静脉孤立性血栓形成直径超过7 mm时，小腿DVT是肺栓塞的来源。比目鱼肌静脉是小腿DVT最常见和最重要的部位，提示这些静脉是严重PE的偶发栓子来源。
