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Advice on preventing DVT

I read with interest that the Scottish Intercollegiate Guidelines Network has issued GPs guidance on the prevention of deep vein thrombosis (News, November 11).

Apparently the guidance states that GPs should consider prescribing aspirin before travel. In my opinion, DVT is a venous not an arterial problem. It is not related to platelets, but stasis.

Aspirin is used in arterial conditions and it is worth remembering that there is no such thing as a venous atheroma.

The danger of using aspirin is that it can lead to gastrointestinal bleeding, especially if taken concomitantly with alcohol, and should actually be contraindicated in air travel.

Dr KA Jafri

Longton, Stoke-on-Trent

There is now good evidence that aspirin reduces the risk of symptomatic DVT and pulmonary embolism, presumably by reducing platelet aggregation which initiates DVT.

For this reason, aspirin is one of several options for prevention of DVT that can be considered for patients at high risk undergoing long-distance travel.

The SIGN guidelines note that aspirin can cause gastrointestinal bleeding and recommends that this risk be discussed with such patients considering aspirin.

The guidelines also recommend further research on the risks and benefits of aspirin (as well as heparins) in persons undergoing long-distance travel.

Professor GDO Lowe

c/o SIGN Executive

Edinburgh

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