Abstract
Case records of 237 patients treated by inferior vena cava (IVC) ligation (154), suture plication (27) or clip application (56) were reviewed. Indications for surgery included failure of anticoagulation or femoral vein ligation to control embolism and threat of potentially massive, septic or paradoxical emboli. Overall hospital mortality was 15% and recent operative mortality was 2%. The incidence of early postoperative leg swelling was 36% and late venous sequellae occurred in 50% of the follow-up group of 140 cases followed an average of 44.3 months. Morbidity secondary to IVC interruption was decreased by use of the prosthetic lip, but clip application was still associated with early leg swelling in 21% and late mild swelling in 24%. The incidence of proven or suspected recurrent emboli was 7.6% with no significant variation by type of IVC procedure, and recurrent emboli were fatal in 2.5%. Refinement of indications, operative methods and perioperative care for IVC interruption procedures over the years has substantially improved the surgical approach to prevention of life-threatening pulmonary embolism.
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Selected References
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- Adams J. T., Feingold B. E., DeWeese J. A. Comparative evaluation of ligation and partial interruption of the inferior vena cava. Arch Surg. 1971 Aug;103(2):272–276. doi: 10.1001/archsurg.1971.01350080188029. [DOI] [PubMed] [Google Scholar]
- CRANE C. Deep venous thrombosis and pulmonary embolism; experience with 391 patients treated with heparin and 126 patients treated by venous division, with a review of the literature. N Engl J Med. 1957 Jul 25;257(4):147–157. doi: 10.1056/NEJM195707252570401. [DOI] [PubMed] [Google Scholar]
- CRANE C. FEMORAL VS. CAVAL INTERRUPTION FOR VENOUS THROMBOEMBOLISM. N Engl J Med. 1964 Apr 16;270:819–822. doi: 10.1056/NEJM196404162701604. [DOI] [PubMed] [Google Scholar]
- Couch N. P., Baldwin S. S., Crane C. Mortality and morbidity rates after inferior vena caval clipping. Surgery. 1975 Jan;77(1):106–112. [PubMed] [Google Scholar]
- Coupland G. A., Reeve T. S. Recurrent pulmonary emboli following inferior vena caval plication. Surgery. 1970 Apr;67(4):639–643. [PubMed] [Google Scholar]
- DALE W. A. Ligation of the inferior vena cava for thromboembolism. Surgery. 1958 Jan;43(1):24–44. [PubMed] [Google Scholar]
- DONALDSON G. A., WILLIAMS C., SCANNELL J. G., SHAW R. S. A reappraisal of the application of the Trendelenburg operation to massive fatal embolism. Report of a successful pulmonary-artery thrombectomy using a cardiopulmonary bypass. N Engl J Med. 1963 Jan 24;268:171–174. doi: 10.1056/NEJM196301242680402. [DOI] [PubMed] [Google Scholar]
- Dalen J. E., Alpert J. S. Natural history of pulmonary embolism. Prog Cardiovasc Dis. 1975 Jan-Feb;17(4):259–270. doi: 10.1016/s0033-0620(75)80017-x. [DOI] [PubMed] [Google Scholar]
- Gazzaniga A. B., MacArthur J. D. Blood volume, cardiac output, and renal function changes after plication of the inferior vena cava. Ann Surg. 1969 Apr;169(4):483–488. doi: 10.1097/00000658-196904000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Greenfield L. J. Pulmonary embolism: diagnosis and management. Curr Probl Surg. 1976 Apr;13(4):1–52. doi: 10.1016/s0011-3840(76)80017-2. [DOI] [PubMed] [Google Scholar]
- Greenfield L. J., Zocco J., Wilk J., Schroeder T. M., Elkins R. C. Clinical experience with the Kim-Ray Greenfield vena caval filter. Ann Surg. 1977 Jun;185(6):692–698. doi: 10.1097/00000658-197706000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hunter J. A., Dye W. S., Javid H., Najafi H., Goldin M. D., Serry C. Permanent transvenous balloon occlusion of the inferior vena cava: experience with 60 patients. Ann Surg. 1977 Oct;186(4):491–499. doi: 10.1097/00000658-197710000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lindenauer S. M. Prophylactic staple plication of the inferior vena cava. Arch Surg. 1973 Nov;107(5):669–675. doi: 10.1001/archsurg.1973.01350230027007. [DOI] [PubMed] [Google Scholar]
- MOZES M., ADAR R., BOGOKOWSKY H., AGMON M. VEIN LIGATION IN THE TREATMENT OF PULMONARY EMBOLISM. Surgery. 1964 May;55:621–629. [PubMed] [Google Scholar]
- Miles R. M., Elsea P. W. Clinical evaluation of the serrated vena caval clip. Surg Gynecol Obstet. 1971 Apr;132(4):581–587. [PubMed] [Google Scholar]
- Parrish E. H., Adams J. T., Pories W. J., Burget D. E., DeWeese J. A. Pulmonary emboli following vena caval ligation. Arch Surg. 1968 Dec;97(6):899–909. doi: 10.1001/archsurg.1968.01340060077008. [DOI] [PubMed] [Google Scholar]
- Piccone V. A., Jr, Vidal E., Yarnoz M., Glass P., LeVeen H. H. The late results of caval ligation. Surgery. 1970 Dec;68(6):980–998. [PubMed] [Google Scholar]
- Pollak E. W., Sparks F. C., Barker W. F. Inferior vena cava interuption: indications and results with caval ligation, clips and intracaval devices in 110 cases. J Cardiovasc Surg (Torino) 1974 Nov-Dec;15(6):629–635. [PubMed] [Google Scholar]
- Strandness D. E., Jr, Ward K., Krugmire R., Jr The present status of acute deep venous thrombosis. Surg Gynecol Obstet. 1977 Sep;145(3):433–445. [PubMed] [Google Scholar]
- Wingerd M., Bernhard V. M., Maddison F., Towne J. B. Comparison of caval filters in the management of venous thromboembolism. Arch Surg. 1978 Nov;113(11):1264–1271. doi: 10.1001/archsurg.1978.01370230054006. [DOI] [PubMed] [Google Scholar]
