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Anatomical consideration of deep calf veins: application to catheter-directed thrombolysis

Kyu-Ho Yi1,2, Jong-Jin Lee2,3, Hye-Won Hur2

  • 1Wonju Public Health Center, COVID-19 Division, Wonju-Si, Korea.

Surgical and Radiologic Anatomy : SRA
|August 25, 2021
PubMed

Insights

The proximal posterior tibial vein and anterior tibial vein offer the best venous access for antegrade catheter-directed thrombolysis due to their larger diameters and surface areas, unlike smaller calf veins.

Area of Science:

  • Vascular anatomy
  • Interventional radiology

Background:

  • Antegrade approach is common for deep vein thrombosis (DVT) catheter-directed thrombolysis.
  • Accessing small diameter veins can be challenging for this procedure.
  • Understanding deep calf vein variations is crucial for optimal access.

Purpose of the Study:

  • To determine the most suitable deep calf veins for venous access in antegrade catheter-directed thrombolysis.
  • To analyze the anatomical variations of key deep calf veins.

Main Methods:

  • Dissection of 132 Korean and Thai cadaver legs.
  • Measurement of diameters and surface areas of proximal and distal posterior tibial, peroneal, and anterior tibial veins.
  • Scanning and measurement of selected veins.

Main Results:

  • Proximal posterior tibial vein had the largest mean diameter (6.34 mm) and surface area (0.312 cm²).
  • Anterior tibial vein also showed significant size (5.22 mm diameter, 0.213 cm² surface area).
  • Distal posterior tibial and peroneal veins were smaller and less suitable for access.

Conclusions:

  • Proximal posterior tibial and anterior tibial veins are ideal for antegrade thrombolysis access.
  • Distal posterior tibial and peroneal veins are not recommended due to smaller dimensions and anatomical variability.
Abstract

Keywords:
Anterior tibial veinCatheter-directed thrombolysisDeep calf veinDeep-vein thrombosisDiameterPeroneal veinPosterior tibial veinSurface area

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