Pulmonary clots not caused by DVT

Pulmonary blood clots are primarily formed in situ, rather than being the result of dislodged peripheral clots, US research suggests.

George Velmahos and colleagues from Harvard Medical School studied 247 trauma patients between 2004 and 2006.

Patients underwent scans of the lungs and veins in the pelvis and legs.

Pulmonary embolism did not seem to be associated with deep vein thrombosis (DVT).

Around one in five of the patients (46 in total) had pulmonary embolism and one in 14 had DVT. However only seven patients (15 per cent) had both pulmonary embolism and DVT.

'Based on these data, there is little evidence that pulmonary embolism originated from DVT of peripheral veins,' the researchers concluded.

Dr Velmahos and colleagues believe that this is the first study to bring into question the traditional belief that pulmonary embolism originates from pelvic and proximal lower extremity veins.

'As computed tomographic venography becomes more popular and accurate, this issue will be further explored, and it may be revealed that (not surprisingly) we have been preaching and practising the wrong dogma for years,' the researchers said.

  • Archives of Surgery Online 2009

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