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Deep Vein Thrombosis: Diagnosis and Treatment Reviewed
Henry I. Bussey, Pharm.D.
November, 2006
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:
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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)
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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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