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Deep vein or tributary

Deep vein or tributary


Answer

  1. Thank you for the great question.

    The deep veins of the lower limb are characterised by their location deep to the fascia. The infrapopliteal deep veins are typically separated into axial veins (posterior tibial vein, anterior tibial vein, peroneal vein, tibioperoneal trunk) and muscular veins (medial and lateral gastrocnemius and soleal veins). 

    They are still classified as a DVT; however, using the muscular vein thrombosis terminology may help in the reporting process. It's also important to refer back to your local policies and guidelines, as variability will exist between reporting radiologists. 

    There is, of course, a range of anatomical variations in the gastrocnemius vein drainage. I've copied a paper below for you to read through if you wish.

    Anatomical Study of the Gastrocnemius Venous Network and Proposal for a Classification of the VeinsAragão, J.A. et al.European Journal of Vascular and Endovascular Surgery, Volume 31, Issue 4, 439 - 442

    I've added some information on the "chronic" DVT reporting issue. The consensus now prefers the use of terms such as post-thrombotic scarring/post-thrombotic change or synechiae over chronic DVT. This helps reduce confusion for clinicians outside of the vascular world to act on the results.

    Needleman L, Cronan JJ, Lilly MP, et al. Ultrasound for Lower Extremity Deep Venous Thrombosis: Multidisciplinary Recommendations From the Society of Radiologists in Ultrasound Consensus Conference. Circulation. 2018;137(14):1505-1515. doi:10.1161/CIRCULATIONAHA.117.030687

    Apologies for the delayed response, as I was on holidays.

    Kind Regards

    Heath/Vascular SIG


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