Prevention of Deep Vein Thrombosis and Pulmonary Embolism

  • J. G. Sharnoff


Ever since Crafoord15 recommended the use of postoperative intravenous heparin in the prevention of thrombosis, many routines have been tried. The methods of prevention of deep vein thrombosis has had two main attacks based on two of the postulates of Virchow’s original triad. The first attack was based on the assumption that slowing of the blood flow in the leg veins was the chief cause of deep vein thrombosis. This prompted the trial of early mobilization and ambulation following surgery. Then followed leg elevation, the wearing of elastic stockings89, massage of the lower limbs, electrical stimulation of the calf muscles during surgery and the application of pneumatic boots81 during surgery. These methods appeared to have had some beneficial effect in reducing the incidence of deep vein thrombosis but to a limited extent. Another method believed to improve blood flow was the use of the plasma expander dextran. More recently it has been shown that dextran7,10,29,33 may also impair platelet aggregation and adhesiveness, an important cause of intravascular thrombosis. In addition, it has been described as a thrombolytic agent in the dissolution of already formed thrombi. Reports with the use of dextran 40 and 70 are contradictory, however. They also have adverse effects such as the overloading of the circulation and the necessity of repeated venous injections29,30,82.


Aspirin Nicotinate Heparin Immobilization Coumadin 


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© J. G. Sharnoff 1980

Authors and Affiliations

  • J. G. Sharnoff
    • 1
  1. 1.The Mount Vernon HospitalMount VernonUSA

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