The significance of isolated calf deep vein thrombosis (ICDVT) remains unclear with current guidelines not being based on strong level of evidence. Given the uncertainties, the therapeutic approaches vary among institutions; hence, it is prudent to look at existing experience of an institution where examination of calf veins is routinely done during venous duplex ultrasound of the lower extremities.

Using an analytical retrospective cohort design, this study investigated the clinical profile and outcomes of patients noted to have ICDVT on venous duplex scan at a single tertiary center from October 1, 2018 to June 30, 2023.

A total of 151 subjects were included in the study. Most of the cases had either stabilization (36.42%, 95% CI: 28.75%-44.64%) or complete resolution (35.76%, 95% CI: 28.14%-43.96%) of ICDVT. Recurrence occurred in 15.89% (95% CI: 10.46%-22.72%) while proximal DVT extension only occurred in 10.60% (95% CI: 6.18-16.64%) of the subjects. None of the factors studied, including therapeutic management, were significantly associated with proximal DVT extension, recurrence, pulmonary embolism and stabilization of ICDVT. When it comes to resolution of ICDVT, only therapeutic management was found to have significant association.

Previously cited medical risk factors do not play a role in the development of ICDVT complications. While anticoagulation contributes to resolution of ICDVT, it can safely be managed conservatively in cases of high bleeding risk.