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August 8, 1966

Venous Ligation Or Anticoagulants?

JAMA. 1966;197(6):42. doi:10.1001/jama.1966.03110060022008

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When diagnosis of recurrent pulmonary embolism is made, the physician often has the choice of relying upon anticoagulants for its control or venturing a venous ligation.

At Peter Bent Brigham Hospital, Boston, venous ligation is usually the procedure of choice.

"We realize that there are many centers where venous ligation is not done, reliance being placed upon anticoagulants," Edward A. Edwards, MD, senior associate in surgery, told a recent symposium on vascular diseases. The symposium was sponsored by the Albert Einstein Medical Center, Philadelphia.

Supporting Evidence  Nevertheless, there is strong supporting evidence, both pathological and experimental, to justify going immediately to a venous ligation.Autopsy studies have shown that vascular volume in the lungs of persons with pulmonary emboli is often reduced to 1/2 to 1/3 normal. Experiments in dogs have also shown that this degree of vascular obstruction is necessary to cause a significant rise in pulmonary resistance and