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Significance of Isolated Calf Vein Thrombosis—Further Evidence

Significance of Isolated Calf Vein Thrombosis—Further Evidence Significance of Isolated Calf Vein Thrombosis Invited Commentary Invited Commentary Xuan-Binh D. Pham, MD; Christian de Virgilio, MD Clotting or bleeding? Which is worse? Surgeons grapple with DVT. The authors found that the intention to administer an- this age-old conundrum every day. When we err on the side ticoagulation reduced the risk for a composite outcome of PE of withholding anticoagulants, we face the former, whereas ag- or proximal DVT propagation by two-thirds. A cautionary find- gressive blood thinning inevitably risks the latter. With the ing was that the risk for significant bleeding associated with growing body of evidence that calf deep vein thrombosis (DVT) anticoagulation was 9%, which was a 4-fold higher rate than can lead to proximal clot propagation and pulmonary embo- among controls and included 1 death. Interestingly, patients lism (PE), the same risk-benefit analysis is now being invoked with muscular branch (soleal or gastrocnemial) calf DVT ben- for calf DVT. Some argue that the risks of simply observing a efitted the most from anticoagulation, as did those with a pro- calf DVT are low, but others voked DVT, findings that are supported and contradicted by 5-7 have linked calf DVT to mas- the established literature. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Surgery American Medical Association

Significance of Isolated Calf Vein Thrombosis—Further Evidence

JAMA Surgery , Volume 151 (9) – Sep 20, 2016

Significance of Isolated Calf Vein Thrombosis—Further Evidence

Abstract

Significance of Isolated Calf Vein Thrombosis Invited Commentary Invited Commentary Xuan-Binh D. Pham, MD; Christian de Virgilio, MD Clotting or bleeding? Which is worse? Surgeons grapple with DVT. The authors found that the intention to administer an- this age-old conundrum every day. When we err on the side ticoagulation reduced the risk for a composite outcome of PE of withholding anticoagulants, we face the former, whereas ag- or proximal DVT propagation by two-thirds. A cautionary find-...
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Publisher
American Medical Association
Copyright
Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6254
eISSN
2168-6262
DOI
10.1001/jamasurg.2016.1799
pmid
27438784
Publisher site
See Article on Publisher Site

Abstract

Significance of Isolated Calf Vein Thrombosis Invited Commentary Invited Commentary Xuan-Binh D. Pham, MD; Christian de Virgilio, MD Clotting or bleeding? Which is worse? Surgeons grapple with DVT. The authors found that the intention to administer an- this age-old conundrum every day. When we err on the side ticoagulation reduced the risk for a composite outcome of PE of withholding anticoagulants, we face the former, whereas ag- or proximal DVT propagation by two-thirds. A cautionary find- gressive blood thinning inevitably risks the latter. With the ing was that the risk for significant bleeding associated with growing body of evidence that calf deep vein thrombosis (DVT) anticoagulation was 9%, which was a 4-fold higher rate than can lead to proximal clot propagation and pulmonary embo- among controls and included 1 death. Interestingly, patients lism (PE), the same risk-benefit analysis is now being invoked with muscular branch (soleal or gastrocnemial) calf DVT ben- for calf DVT. Some argue that the risks of simply observing a efitted the most from anticoagulation, as did those with a pro- calf DVT are low, but others voked DVT, findings that are supported and contradicted by 5-7 have linked calf DVT to mas- the established literature.

Journal

JAMA SurgeryAmerican Medical Association

Published: Sep 20, 2016

References

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