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Deep Vein Thrombosis: Diagnosis and Treatment Reviewed
Henry I. Bussey, Pharm.D.
Reference: Scarvelis D, Wells PS. Diagnosis and Treatment of Deep Vein Thrombosis. CMAJ. 2006 Oct 24;175(9):1087-92.
For those not intimately familiar with the current data or for students, this review by two experts in the field provides a very nice overview of recent advances in the diagnosis and treatment of deep vein thrombosis - including a pre-test probability scoring scheme for the initial clinical assessment of the patient in whom DVT is suspected. Two areas with which some clinicians might disagree are:
The authors' position that an INR target above 2 to 3 is not indicated in patients with antiphospholipid antibodies (see the article by Ortel at http://www.clotcare.com/clotcare/
apsandlupusanticoagulant.aspx for an alternative view)
The authors may be more inclined to use retrievable inferior vena cava filters in pregnancy than others may be.
Otherwise, the paper appears to be an up-to-date, succinct, and clinically useful review of this important topic.
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Saturday, April 29, 2017