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Dextran vs Heparin in Thrombophlebitis

Victor Gurewich, MD; Duncan P. Thomas, MD
JAMA. 1965;192(5):426. doi:10.1001/jama.1965.03080180084042.
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To the Editor:—  The effectiveness of anticoagulants in the treatment of venous thrombosis and embolism has been clearly established by a number of well-controlled clinical and experimental studies. The recent advocacy of dextran as an alternate and possibly superior mode of therapy in this disease therefore requires especially careful evaluation. In the March 1 issue of The Journal (191:740-742) Sawyer and associates present their interesting observations on "Dextran Therapy in Thrombophlebitis," on which we would like to comment.The classification of "nonembolic thrombophlebitis" seems to us a particularly treacherous one since pulmonary emboli are notoriously difficult to diagnose and their incidence at autopsy so far exceeds the most sophisticated clinical awareness. In practice, it therefore seems more reasonable and perhaps safer to consider every case of deep venous thrombosis as an example of "venous thromboembolic disease." This implies that therapy must be evaluated on the basis of its effect

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