Deep vein thrombosis classification scheme

Editor(s)-In-Chief: The APEX Trial Investigators, C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] Ujjwal Rastogi, MBBS [3]; Kashish Goel, M.D.; Assistant Editor(s)-In-Chief: Justine Cadet

Deep Vein Thrombosis Microchapters
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Differentiating Deep vein thrombosis from other Diseases
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Overview

Deep vein thrombosis (DVT) is classified based on the site of occlusion or clot formation. Symptom presentation and complication is largely influenced by location of the embolus.

Classification based on site of thrombus formation

• Upper extremity DVT: DVT of the upper limbs.
• Lower extremity DVT: DVT of the lower limbs, which is subdivided into two categories:
  • Proximal vein thrombosis.
  • Distal (calf) vein thrombosis.

Proximal vein thrombosis

Proximal vein thrombosis involves the proximal veins, including the popliteal, femoral or iliac vein. Proximal vein thrombosis is responsible for more than 90 percent of acute pulmonary emboli and is associated with higher mortality. Clinically, proximal vein thrombosis is considered severe, as it is more commonly associated with serious, chronic diseases, such as:

• Active cancer.
• Congestive heart failure.
• Old age (greater than 75 years).
• Respiratory insufficiency.

More than 90 percent of cases of acute pulmonary embolism are due to emboli emanating from the proximal, rather than the distal vein (ie, below the knee), veins of the lower extremities and the mortality rate of proximal DVT is higher than that of distal DVT .

Distal vein thrombosis

Distal or calf deep vein thrombosis involves infrapopliteal veins [ie, posterior tibial veins, peroneal veins, anterior tibial veins and muscular calf veins (soleal or gemellar veins)]. It is often associated with transient risk factors, such as:

• Recent surgery.
• Immobilization.
• Travel.

Distal vein thrombosis is more often associated with transient risk factors, such as:

• Recent surgery.
• Immobilization.
• Travel.