June 1966

Vena Cava Clip Plication

Author Affiliations

From the Cardiovascular Department, St. Elizabeth Hospital, Youngstown, Ohio.

Arch Surg. 1966;92(6):940-942. doi:10.1001/archsurg.1966.01320240128027

IN THE middle of the 19th century Rudolph Virchow was the first to describe pulmonary emboli and to understand their origin in the femoral and pelvic veins.1 However, it was not until 1910 that Trendelenberg first ligated the inferior vena cava as definitive treatment for the prevention of pulmonary embolism.2 By 1948, there were only 48 cases reported.3,4

Caval ligation has been used as a last resort and a life-saving measure but has never gained wide popularity because of its postoperative sequelae of edema, arteriospastic phenomena, fibrosis, and ulceration of the lower extremities.5-9 This prompted many investigators to search for other methods which would prevent pulmonary embolism but without the unpleasant sequelae of caval ligation.7 Ligation of the inferior vena cava with absorbable ligatures with the hope that the cava would reopen after the acute phase was unreliable and unpredictable.10,11

A one loop straight

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