Highlights the clinical scenarios where venous interruption is favored over anticoagulant therapy for preventing pulmonary embolism.
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Guides cautious use of venous interruption in select anticoagulation-intolerant patients; leaves open the need for randomized trials to refine indications.
AS hospitalized patients in increasing numbers survive a multiplicity of other medical and surgical crises, pulmonary embolism continues as a chief immediate cause of death. Although anticoagulant suppression of intravascular clotting has provided effective protection from embolism in innumerable cases, in many clinical settings, venous ligation above the thrombus, as proposed by Homans1 in 1939, is the treatment of choice.Situations Favoring Venous InterruptionIn addition to patients manifesting coagulation defects or established bleeding lesions, the embolic failures of adequate anticoagulant therapy and those having repeated thromboembolic episodes are prime candidates for venous interruption. On surgical services recent operation on . . .
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Chilton Crane (1964) studied this question.
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