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June 1964

Critical Evaluation of Vena Cava PlicationPrevention of Pulmonary Embolism

Arch Surg. 1964;88(6):1016-1020. doi:10.1001/archsurg.1964.01310240112021

Appearances are deceptive

Aesop: "The Fable of the Wolf in Sheep's Clothing"

A multiplicity of medical and surgical techniques are advocated today in the prevention of pulmonary embolization. The existence of many when one would suffice is evidence of need for a better method of preventing this lethal condition. Unfortunately, the frequency of pulmonary embolus has not decreased during the past 50 years despite increased interest in this condition, improved diagnostic methods, and apparently improved methods of therapy.6,11

Among the several therapeutic regimens advocated in treatment of thromboembolism, anticoagulant drugs have been most widely accepted. The use of adequate anticoagulation is effective in reducing the morbidity and the mortality of major vein thrombosis and pulmonary embolization.8 Both the number of recurrent emboli and the percentage of fatalities attributable to them are decreased.4 In this regard, heparin has appeared to be superior to the prothrombin depressants.12

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