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February 22, 1985

Prophylaxis of Postoperative Deep Venous Thrombosis

Author Affiliations


JAMA. 1985;253(8):1120. doi:10.1001/jama.1985.03350320040007

To the Editor.—  The results of a multicenter trial of dihydroergotamine-heparin in the prophylaxis of postoperative deep vein thrombosis1 concluded that a combination of dihydroergotamine mesylate, 0.5 mg, and heparin sodium, 5,000 IU, given subcutaneously twice daily, is superior to low-dose heparin alone. The criterion for deep vein thrombosis was a positive radiofibrinogen uptake test (RFUT) finding. We have reported the results of a randomized trial, based on 181 patients who underwent major abdominal surgery, comparing dihydroergotamine-heparin v heparin as prophylaxis for deep vein thrombosis.2 We employed the RFUT as a screening procedure. Patients with a positive RFUT finding were subjected to ascending phlebography. The criterion for deep vein thrombosis was an abnormal phlebogram. There were two false-positive results for RFUTs in the patient group receiving dihydroergotamine-heparin and 11 false-positive results in the group given heparin only. Abnormal results of the RFUT were significantly more frequent in the heparin