Illustration of calf-squeeze technique aiding blood flow in DVT treatment.

Squeeze Away the Clot: A Novel Technique for Deep Vein Thrombosis Treatment

Jordan Keane in Health & Wellness July 2025 • 4 min read.

"Discover how a simple calf-squeeze technique is enhancing aspiration thrombectomy for acute lower extremity deep vein thrombosis, improving patient outcomes and simplifying recovery."

Deep vein thrombosis (DVT), particularly in the lower extremities, can lead to significant pain and long-term complications if not treated effectively. Traditional treatments range from anticoagulation therapy to more invasive procedures like surgical thrombectomy.

In recent years, catheter-directed thrombolysis (CDT) and percutaneous mechanical thrombectomy (PMT) have emerged as vital options, aiming to rapidly reduce thrombus burden and preserve venous valve function. However, a common challenge remains: thrombi located below the point of popliteal vein access often persist post-treatment.

A recent study published in the Korean Society of Radiology explores an innovative approach to this problem: the calf-squeeze technique during aspiration thrombectomy. This simple yet effective method aims to encourage proximal migration of thrombi, facilitating more complete removal and improving overall patient outcomes.

The Calf-Squeeze Technique: Enhancing Thrombectomy Outcomes

Illustration of calf-squeeze technique aiding blood flow in DVT treatment.

The calf-squeeze technique involves manual compression of the calf muscles during aspiration thrombectomy. This action helps to propel thrombi located in the popliteal, tibial, and muscular veins upwards, towards the point of catheter access. By encouraging this proximal migration, doctors can more effectively remove residual thrombi, leading to better recanalization and reduced risk of recurrence.

Researchers conducted a prospective analysis of ten patients with acute lower extremity DVT, all of whom presented with common iliac vein (CIV) obstruction and ipsilateral DVT. The treatment protocol involved:

Initial catheter-directed thrombolysis via popliteal vein approach.
Placement of a temporary inferior vena cava (IVC) filter to prevent pulmonary embolism.
Aspiration thrombectomy using a guiding catheter to remove residual thrombus.
Application of the calf-squeeze technique during aspiration to promote thrombi migration.

The calf-squeeze technique was employed an average of 1.3 times per patient, with all patients experiencing proximal migration of thrombi. Successful recanalization was achieved in all patients (100%) without any complications. Follow-up duplex ultrasonography revealed that while some patients had residual thrombus in the soleal muscular veins immediately post-procedure, none had thrombus in the popliteal or tibial veins, and no DVT recurrence was reported during the follow-up period.

Simple Technique, Significant Impact

The study highlights the potential of the calf-squeeze technique as a valuable adjunct to aspiration thrombectomy for acute lower extremity DVT. By facilitating proximal migration of thrombi, this simple maneuver enhances the effectiveness of thrombus removal, leading to improved patient outcomes and reduced risk of recurrence. While further randomized studies are needed to confirm these findings, the initial results are promising and suggest that the calf-squeeze technique could become a standard component of DVT treatment protocols.

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Everything You Need To Know

What is the calf-squeeze technique and how does it improve Deep Vein Thrombosis (DVT) treatment?

The calf-squeeze technique is a manual compression method applied during aspiration thrombectomy. Its primary function is to encourage the proximal migration of thrombi, which are blood clots, located in the popliteal, tibial, and muscular veins. By facilitating the movement of these thrombi towards the point of catheter access, the technique allows for more effective removal of the clots. This leads to better recanalization and reduces the risk of DVT recurrence, ultimately improving patient outcomes in the treatment of acute lower extremity DVT.

How does the calf-squeeze technique work in conjunction with aspiration thrombectomy?

The calf-squeeze technique acts as an enhancement to aspiration thrombectomy. During the procedure, while the aspiration thrombectomy is underway using a guiding catheter, the calf muscles are manually compressed. This action helps to physically propel the thrombi upwards, towards the catheter, making them easier to extract. The combined approach of aspiration thrombectomy and the calf-squeeze technique aims for more complete thrombus removal, which in turn improves the success rate of the procedure.

What other treatments are available for Deep Vein Thrombosis (DVT) besides the calf-squeeze technique, and how do they differ?

Besides the calf-squeeze technique, other treatments for DVT include anticoagulation therapy, surgical thrombectomy, catheter-directed thrombolysis (CDT), and percutaneous mechanical thrombectomy (PMT). Anticoagulation therapy uses medications to prevent new clots from forming and existing clots from getting bigger. Surgical thrombectomy is a more invasive procedure involving direct removal of the clot. CDT involves delivering clot-busting drugs directly to the clot via a catheter. PMT uses mechanical devices to break up and remove the clot. The calf-squeeze technique is specifically used in combination with aspiration thrombectomy to improve the removal of thrombi, particularly in lower extremity DVT cases.

In the study, what was the treatment protocol that included the calf-squeeze technique, and what were the results?

The treatment protocol in the study comprised of: Initial catheter-directed thrombolysis via popliteal vein approach; placement of a temporary inferior vena cava (IVC) filter to prevent pulmonary embolism; aspiration thrombectomy using a guiding catheter; and the application of the calf-squeeze technique during aspiration to promote thrombi migration. The results showed successful recanalization in all patients, with no complications. While some patients had residual thrombus in the soleal muscular veins immediately post-procedure, none had thrombus in the popliteal or tibial veins, and no DVT recurrence was reported during the follow-up period.

What are the implications of using the calf-squeeze technique in treating DVT, and what future research is needed?

The use of the calf-squeeze technique has significant implications, primarily enhancing the effectiveness of aspiration thrombectomy for acute lower extremity DVT. By improving thrombus removal, this technique leads to better patient outcomes and reduced risk of recurrence. The initial results are promising, suggesting it could become a standard component of DVT treatment protocols. Future research should focus on conducting further randomized studies to confirm these findings and assess the long-term efficacy and broader applicability of the calf-squeeze technique within various patient populations and DVT scenarios.