Advertisement
Surgery
Advanced searchSave search
Original communication| Volume 17, ISSUE 2, P178-190, February 1945

Etiology and prevention of thrombosis of the deep leg veins

A study of 400 cases
DOI:https://doi.org/10.5555/uri:pii:0039606045901784
Etiology and prevention of thrombosis of the deep leg veins
Previous ArticleThe problem of thrombo-embolism
Next ArticlePostoperative pulmonary embolism
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      • 1.
        1. A comparative study of the incidence of venous thrombosis of the legs in 400 unselected autopsies on adults, performed in the same hospital, before and after instituting preventive measures is presented.
      • 2.
        2. In the last 200 cases dissection of the femoral and adductor veins was carried out. Like others who have examined the femoral vein, we find that phlebothrombosis of the lower extremities begins in the deep vessels of the calf and tends to propagate toward the heart, and that thrombosis of the femoral veins alone is an uncommon occurrence. Both sets of veins are the most frequent, and for this reason the most important, of all the possible sources of both fatal and nonfatal pulmonary emboli.
      • 3.
        3. There were no important differences between the two series concerning age, sex, or location of the thrombosed calf veins. The lastmentioned feature has been considered in some detail in a previous publication.9
      • 4.
        4. Thrombosis of the deep veins of the leg is a frequent event in all classes of middle-aged and older patients who for any reason whatsoever must go to bed for longer than a very few days. The onset is insidious and without prominent symptoms. Phlebitis, as a cause or as a complication of deep extremity vein thrombosis, is very uncommon and for this reason is unimportant.
      • 5.
        5. The logical approach to the problem of phlebothrombosis and pulmonary embolism is prophylactic. Hitherto, in our opinion, there has been far too much emphasis upon diagnosis and treatment and too little on prevention.
      • 6.
        6. Prophylaxis is best based on simple and readily carried out physiologic principles.
      • 7.
        7. Re-education of physicians and nurses with respect to the seats and causes of thrombosis of the legs is urgently needed.
      • 8.
        8. The incidence of phlebothrombosis in a small series of medical patients proved to be significantly less than it was in the first 200 cases. It seems probable that the institution of active exercises for this group is responsible for the decrease.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Ochsner Alton
        • DeBakey Michael
        Thrombophlebitis and Phlebothrombosis, The C. Jeff Miller Lecture.
        South. Surgeon. 1939; 8: 269-290
        • Frykholm Ragnar
        The Pathogenesis and Mechanical Prophylaxis of Venous Thrombosis.
        Surg., Gynec. & Obst. 1940; 71: 307-312
        • Denecke K.
        Der Plantarschmerz als Frühsymptom einer beginnenden Thrombose der unteren Extremität.
        München. med. Wchnschr. 1929; 76 (Cited by Frykholm.2): 1912-1913
        • Olow J.
        Sur en détail concernant le diagnostic de la thrombose crurale.
        Acta obst. et gynec. Scandinav. 1930; 10 (Cited by Frykholm.2): 159-162
        • Homans John
        Thrombosis of the Deep Veins of the Lower Leg, Causing Pulmonary Embolism.
        New England J. Med. 1934; 211: 993-997
        • Rössle R.
        Ueber die Bedeutung und die Entstehung der Wadenvenenthrombosen.
        Virchow's Arch. f. path. Anat. 1937; 300: 180-189
        • Neumann R.
        Ursprungszentren und Entwicklungsformen der Bein-Thrombose.
        Virchow's Arch. f. path. Anat. 1938; 301: 708-735
        • Putzer Rita
        Die Wadenvenen Thrombose in ihrer Beziehung zur Architektur der Wade.
        Arch. f. Gynäk. 1939; 169: 444-452
        • Hunter Warren C.
        • Sneeden Vinton D.
        • Robertson Thomas D.
        • Snyder George A.C.
        Thrombosis of the Deep Veins of the Legs; Its Clinical Significance as Exemplified in Three Hundred and Fifty-one Autopsies.
        Arch. Int. Med. 1941; 68: 1-17
        • Smith L.A.
        • Allen E.V.
        Vascular Clinics; XIV. Studies on the Rate of Venous Blood Flow; Physiologic Studies and Relation to Postoperative Venous Thrombosis and Pulmonary Embolism.
        in: Proc. Staff Meet., Mayo Clin. 16. 1941: 53-57
        • Potts Willis J.
        • Smith Sidney
        Pulmonary Embolism; An Experimental Study of Variations in the Volume Blood Flow in the Interior Vena Cava of the Dog.
        Arch. Surg. 1941; 42: 661-664
        • Luckhardt Arno B.
        • Alpert Ruth
        • Smith Sidney
        Hemodynamic and Respiratory Changes Following Manipulation and Traction of the Gastrohepatic Ligament.
        Science. 1932; 76: 545
        • Simpson K.
        Shelter Deaths From Pulmonary Embolism.
        Lancet. 1940; 2: 744
        • Dock William
        The Use and Abuse of Bed Rest; Conferences on Therapy, New York Hospital.
        New York State J. Med. 1944; 44: 724-730

      Article info

      Publication history

      Received: August 7, 1944

      Identification

      DOI: https://doi.org/10.5555/uri:pii:0039606045901784

      Copyright

      © 1945 Published by Elsevier Inc.

      ScienceDirect

      Access this article on ScienceDirect
      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties. The content on this site is intended for healthcare professionals.


      RELX