Ligation of the Inferior Vena Cava

THE UNDESIRABLE sequelae to inferior vena caval ligation have been studied and reported by several observers * and these sequelae contribute significantly to a general reluctance on the part of physicians to apply this effective technique as broadly as might otherwise be indicated. Several reports have been pessimistic about these sequelae of caval ligation,2,3,29and have led investigators to search for alternative methods such as temporary and partial ligature techniques.7,16,17Recent interest has centered about plicative and sieve-construction techniques to lessen these sequelae.9,30Other reports are more optimistic,18-22,28and several have observed so few and minimal complications after vena cava ligation that they envision no further practical refinements in technique.14 The observation of minimal early edema and the subsequent improvement for many months after caval ligation among our patients suggested continuing vascular adjustment to ligation over a period of years and prompted a review of our