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June 27, 1977

Medical News

JAMA. 1977;237(26):2799-2809. doi:10.1001/jama.1977.03270530007001

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Low-dose heparin can reduce risks after emergency carotid ligation  Treatment with low doses of heparin sodium can reduce the risk of death or neurological sequelae in cases where the carotid artery has to be ligated during extensive head and neck surgery for cancer.Carotid artery exposure is associated with considerable risk, because this important vessel may rupture or need ligation to avoid rupture. The complication is common enough; in one recently reported series from the University of Cincinnati Medical Center, ligation proved necessary in 20 of 440 patients, or 4.5% of the total.Five of these 20 patients died, ten lived after suffering strokes, and the others survived without neurological sequelae.The outcome was different in seven of 280 patients who had to undergo emergency carotid artery ligation during similar head and neck operations during a later period when low-dose heparin had become part of the standard regimen at