Key result
Pulmonary embolism is associated with a ~26% clinical recurrence rate.
Why the study?
Recurrent pulmonary embolism occurs despite adequate anticoagulant therapy and presents challenges in recognition and management.
Observational (n=416)
No
Vena caval ligation may prevent recurrent PE despite risks; leaves open need for randomized trials versus modern therapy.
The problem of recurrent pulmonary embolism in its varied clinical forms presents a challenge in recognition and management. Despite "adequate" anticoagulant therapy recurrent embolism is apt to occur either during anticoagulant therapy or after the completion of treatment.1Femoral vein ligations have been reported to be of little value in obviating pulmonary embolism.2,3Vena caval ligation, despite its sequelae, has proved to be the most effective tool in the prevention of recurrent pulmonary embolism. The purpose of this paper is to present a clinical analysis of recurrent pulmonary embolism as seen at the Duke University Medical Center since 1950. Corollary physiologic studies in patients with thromboembolic disease undergoing vena caval ligation will also be outlined. Clinical Analysis of Cases Since 1950, we have studied 416 patients with pulmonary embolism seen at the Duke University Medical Center. Of these, 109 had definite clinical evidence of recurrence as judged by
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James F. Schauble (1960) conducted an observational in Pulmonary embolism (n=416). Vena caval ligation was evaluated on Recurrent pulmonary embolism. Among 416 patients with pulmonary embolism evaluated since 1950, 109 had definite clinical evidence of recurrence.
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