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October 1977

Can the Venous System Be Made to Act In Situ for the Arterial System?

Author Affiliations

From the Department of Surgery, Harvard Medical School, Boston.

Arch Surg. 1977;112(10):1238-1239. doi:10.1001/archsurg.1977.01370100092020

This discussion does not concern venous grafts, rather, manipulations that were tried long before the grafting era in an attempt to induce the venous supply to function in situ to assist its arterial system. The hope was to reverse the effects of various forms of arterial occlusion. Two methods have been tried.

Increasing the Venous Pressure  The loss of arterial pressure in a limb distal to an occlusion once tempted many to surmise that increasing the capillary pressure at the venous end would force more nutrients and oxygen across the capillary wall. Hence, a massive and disorganized clinical experiment was undertaken at the time of World War I, consisting of treating gunshot wounds to critical arteries by ligating not only the artery (which had to be done in any case, in those prearterial reconstruction days), but also the concomitant vein. Sporadic clinical successes were reported, but the procedure did not

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