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November 1, 1941


Author Affiliations

Des Moines, Iowa.

JAMA. 1941;117(18):1557. doi:10.1001/jama.1941.02820440065023

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To the Editor:—  A communication to The Journal, August 16, page 553, by Dr. J. M. Hayes questions the safety of high ligation in the treatment of varicose veins. Instead, injection treatment is advocated in the upper part of the thigh as well as in the lower leg.Pulmonary embolism is probably the chief hazard in the treatment of varicose veins. It was the cause of the high mortality of early radical surgical procedures (vein resection, vein stripping and so on), after which patients were of necessity bedfast. Later, with the development of ambulatory injection treatment, embolism became rare.Obviously any form of treatment of varicose veins, whether by surgery, injection or ligation, involves the possibility of embolism, since all forms of treatment produce thrombi. But it seems unlikely that ambulatory ligation of the upper end of the great saphenous vein is more dangerous than the injection of sclerosing agents

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