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Heparin Control of Venous Thromboembolism
W. Andrew Dale, MD;
Malcolm R. Lewis, MD
AMA Arch Surg. 1970;101(6):744-755.
Abstract
The diagnosis and management of 159 episodes of venous thrombosis or embolism in 133 patients is discussed in the light of our experience and the reports of others. Treatment primarily consisted of continuous intravenous heparinization for 7 to 14 days with surgical methods reserved for the few where this was contraindicated or had failed. Six patients died before treatment could begin. Three percent of all treated patients died. The secondary embolism rate for 132 courses of heparin sodium was 3% with 1.5% deaths. Bleeding requiring cessation of therapy occurred in 1.3%, but none died due to this. The ten venous thrombectomies in nine patients and six inferior vena caval interruptions are discussed in relation to the indications for surgical management. Principles of managements are proposed and questions requiring solution are outlined.
Author Affiliations
Nashville, Tenn
From the Vanderbilt University Medical Center, St. Thomas Hospital and Baptist Hospital, Nashville, Tenn.
Footnotes
Accepted for publication Aug 7, 1970.
Read before the 18th scientific meeting of the International Cardiovascular Society, Chicago, June 19, 1970.
Reprint requests to Midstate Medical Center, 2000 Church St, Nashville, Tenn 37203 (Dr. Dale).
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