February 1, 1985

Dihydroergotamine-Heparin Prophylaxis of Postoperative Deep Vein Thrombosis-Reply

JAMA. 1985;253(5):636. doi:10.1001/jama.1985.03350290038020

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In Reply.—  We appreciate Dr Hattersley's interesting and informed comments concerning the utility of an adjusted-dose heparin regimen and the relationship between heavier weight and DVT.In our trial of patients undergoing elective general surgery, we did not include serial APTT measurements and therefore cannot corroborate the findings of Leyvraz et al, who found that adjusting heparin dosage provided a more effective prophylactic regimen. However, we believe that if appropriate prophylactic measures are to be encouraged, the recommended regimens ought to be simple to administer. Adding APTT measurements to adjust heparin prophylaxis dosage merely serves to complicate the regimen, which will only discourage the use of prophylactic measures in the United States.In response to one of the other questions, we found that the percentage of patients with DVT who were above average weight (76.8 kg [170 lb] for men, 70.5 kg [156 lb] for women) was as follows: dihydroergotamine/