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Correspondence |

Are Asymptomatic DVTs Relevant?Management of Asymptomatic DVTs: One Measure for All FREE TO VIEW

Adolfo Llinas, MD; Laura Cardenas, MD
Author and Funding Information

From the Fundacion Sante Fe de Bogota, University Hospital, Orthopedics and Traumatology (Dr Llinas); and Universidad de los Andes (Drs Llinas and Cardenas), Medicine.

Correspondence to: Adolfo Llinas, MD, Avenida 9#116-20 Consultorio 811, Bogotá, Colombia; e-mail: adolfollinas@cable.net.co


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(3):874. doi:10.1378/chest.12-2510
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To the Editor:

Congratulations on publishing the ninth edition of the American College of Chest Physicians Antithrombotic Guidelines (February 2012),1 which are of paramount importance. Orthopedic recommendations for VTE prophylaxis in prior versions of the CHEST guidelines were based on experimental outcomes that combined asymptomatic and symptomatic DVTs. However, the current guidelines exclude from consideration asymptomatic DVTs.1 The designation of asymptomatic DVTs as clinically irrelevant outcomes has changed the calibration of clinical trials, rendering many of the results as not significant. Given the former position, we are puzzled by the observation that asymptomatic DVTs, which are incidentally found, are treated with anticoagulation for a period of 3 to 12 months.2 We would like to ask why the asymptomatic DVTs, if otherwise considered irrelevant in the orthopedic clinical trials, are treated formally with anticoagulation if found incidentally?

References

Falck-Ytter Y, Francis CW, Johanson NA, et al. Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2)(suppl):e278S-e325S. [CrossRef] [PubMed]
 
Kearon C, Akl EA, Camerota AJ, et al. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2)(suppl):e419S-e494S. [CrossRef] [PubMed]
 

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References

Falck-Ytter Y, Francis CW, Johanson NA, et al. Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2)(suppl):e278S-e325S. [CrossRef] [PubMed]
 
Kearon C, Akl EA, Camerota AJ, et al. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2)(suppl):e419S-e494S. [CrossRef] [PubMed]
 
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