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Despite pharmacological prophylaxis, 50% of the surgical patients whose Caprini score is >10 develop VTE in the postoperative period suggesting that anticoagulation alone may not be sufficient especially in these high-risk patients. Clinical studies demonstrate that the clot nidus starts to form during the time of operation. Thus, in the postoperative period when pharmacological prophylaxis is initiated, high-risk patients may have already developed a blood clot for which prophylactic doses of anticoagulants would be suboptimal to treat.
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