—The comments of Dr Partsch generally agree with my suggestion regarding the practical management of DVT. The observational study cited1 found a 7.9% incidence of new pulmonary embolism by ventilation-perfusion scanning or autopsy after 11 days of treatment with anticoagulation and ambulatory hospital management. Since there was no control group of patients managed with bed rest in this study, no firm conclusions can be made regarding the benefit or risk of ambulation. However, the (relatively) low incidence of recurrence in comparison with other published studies suggests that ambulation is not harmful. As the letter suggests, compression stockings can be helpful in the symptomatic management of patients following an acute episode of DVT. I look forward to the publication of the randomized prospective study cited by Partsch regarding the effect of compression stockings on the frequency of postthrombotic syndrome.
Francis CW. Management of Patients With Deep Venous Thrombosis-Reply. JAMA. 1994;272(8):593. doi:10.1001/jama.1994.03520080035037