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October 1952


Author Affiliations

From the Surgical Service of the Veterans Administration Hospital.

AMA Arch Surg. 1952;65(4):605-610. doi:10.1001/archsurg.1952.01260020621014

LIGATION of the inferior vena cava has become a well-established surgical procedure for the prevention of recurrent pulmonary emboli due to venous thrombosis in the lower extremities or pelvis. There are conflicting reports regarding the degree of long-term disability following ligation, ranging from complete absence of symptoms to virtual incapacitation by massive edema, varicosities, and leg ulcers.

Several methods have been used in the past for demonstration of the routes by which blood can return to the heart, circumventing a ligature of the inferior vena cava in the lower lumbar level. Sappey and Dumontpallier,1 in 1862, injected the venous system with tallow via the femoral and axillary veins. They divided the collateral circulation into the anterior, lateral, and posterior channels.

In 1940, Batson,2 working on the monkey and on cadavers, injected radiopaque material into the dorsal vein of the penis and demonstrated part of the potential collateral circulation

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