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Invited Critique |

Searching for the Source of Venous Clots: An Unsolved Old Problem:  Comment on “Pulmonary Embolism and Deep Venous Thrombosis in Trauma: Are They Related?”

Raul Coimbra, MD, PhD
Arch Surg. 2009;144(10):932. doi:10.1001/archsurg.144.10.932.
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Velmahos and colleagues question whether DVT and PE are temporally related following injury. After retrospectively studying 247 patients who underwent CTPA/CTV of the pelvic and proximal lower extremity veins, they concluded that few patients with PE have DVT. They postulate that PE may be formed de novo in the lungs.

The rationale for the study is the fact that, as documented by several other investigators, many patients with PE have no DVT. Or do they—but the diagnostic modalities are just not good enough to diagnose DVT?

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