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December 1961

Use of Fibrinolysin in Experimental Inferior Vena Caval Replacement

Author Affiliations

From the Departments of Surgery, College of Physicians and Surgeons, Columbia University, New York, and the University of Vermont, College of Medicine.

Arch Surg. 1961;83(6):883-886. doi:10.1001/archsurg.1961.01300180083015

Replacement of venous segments remains one of the unsolved problems in vascular surgery. In most instances, the failure is due to thrombotic occlusion of the graft, with the thrombosis originating at the suture line.4

This project was carried out in order to determine the value of fibrinolysin in the prevention of thrombotic occlusion of the inferior vena cava. Venous autografts and various prosthetic materials were compared in both control and test groups because these represent extremes of success and failure in venous replacement.

Bryant2 reports 8 of 10 successful venous autografts used for inferior vena caval replacement. He had no success when using freeze-dried arterial homografts, freeze-dried venous homografts, and a variety of prosthetic grafts. Egdahl5 reports no success with Orlon prostheses. Much work has been done on superior vena caval replacement. Results are conflicting,4 but, in general, fresh venous autografts are most successful, venous and