A F/U- the Rad agreed after seeing eveyone's response in the flownet to call it a DVT. I called the referring doc( who was very pleased with my persistence) and the patient is being admitted for anticoagulation as I write this email.  GOOD JOB UVM flownet. You came to my rescue!!!!!

Patti Shandloff BSN,RVT
Supervisor
Battjes Vascular Institute at Bethesda
Memorial Hospital
Boynton Beach, Fl.
561-731-4000

>>> [log in to unmask] 11/26/02 11:39AM >>>
I hope there will be more input about the gastrocnemius clots; I'd
like to hear more opinions. I think Terry Needham's response is (as
usual) the most sensible: scan again in a few days and be sure it's
not propagating up to the popliteal level.

It seems to me that there are two main reasons to treat thrombosis:
Prevent PE, and try to prevent postphlebitic problems If possible.
I'm not aware of literature on PE's coming from isolated gastroc
clots, but it seems unlikely. Likewise, it seems unlikely that
isolated gastroc clot would cause chronic insufficiency problems.

So the main worry is propagation into the popliteal and proximal
levels, which can be addressed by restudy.

As to the nomenclature, yes, they're sorta deep, but we usually
classify "deep veins" as those accompanying the main arteries, not
every arterial branch. I usually call it "muscular-vein thrombosis"
and avoid the distinction between "superficial" and "deep."

Don Ridgway
Grossmont Hospital

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