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Searching for the Source of Venous Clots: An Unsolved Old ProblemComment on "Pulmonary Embolism and Deep Venous Thrombosis in Trauma: Are They Related?"
Raul Coimbra, MD, PhD
Arch Surg. 2009;144(10):932.
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Velmahos and colleagues question whether DVT and PE are temporally related following injury. After retrospectively studying 247 patients who underwent CTPA/CTV of the pelvic and proximal lower extremity veins, they concluded that few patients with PE have DVT. They postulate that PE may be formed de novo in the lungs.
The rationale for the study is the fact that, as documented by several other investigators, many patients with PE have no DVT. Or do they—but the diagnostic modalities are just not good enough to diagnose DVT?
The issue of diagnosing DVT in trauma patients is an important one. Perhaps more important is the way one screens for DVT. It seems that "the more you look, the more you find," as noted in investigations comparing no screening with once-weekly or twice-weekly screens. The authors used duplex venous ultrasonography weekly for screening and performed CTV as the standard . . . [Full Text of this Article] AUTHOR INFORMATION
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Pulmonary Embolism and Deep Venous Thrombosis in Trauma: Are They Related?
George C. Velmahos, Konstantinos Spaniolas, Malek Tabbara, Hani H. Abujudeh, Marc de Moya, Alice Gervasini, and Hasan B. Alam
Arch Surg. 2009;144(10):928-932.
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