Abstract A proper beginning for this discussion would be to eliminate from the title the word definitive, which is defined as conclusive and final. The list of investigators who have worked on this problem are legion and include those we all revere as past master vascular surgeons. Treatment of the lesion is baffling, and the therapy has run the pendulum from ultraconservative, as described by Owens4 and others, to ultraradical. No one can presume to know all the answers to this problem. By describing all the efforts of those trying to help these patients we may eliminate, at least, the treatments that further complicate the picture. The publications on this subject in the last three years, in summation, agree to disagree. One has only to read his own previous discussions to note how changing are our thoughts on what the post-thrombotic syndrome is and what we should do about it. References 1. Linton, R. R.: Modern Concepts in the Treatment of the Postphlebitic Syndrome with Ulcerations of the Lower Extremity , Angiology 3:431-439, 1952.Crossref 2. Linton, R. R.: The Post-Thrombotic Ulceration of the Lower Extremity: Its Etiology and Surgical Treatment , Ann. Surg. 138:415-432, 1953.Crossref 3. Malan, E.: Syndromes fonctionnels du membre inférieur dus aux communications artérioveineuses de la plante du pied , Lyon chir. 50:641-653, 1955. 4. Owens, J. C., and Anderson, L. L.: Indications for Surgical Treatment of the Postphlebitic Syndrome , Surgery 41:81-93, 1957. 5. Piulachs, P., and Vidal-Barraquer, F.: Pathogenic Study of Varicose Veins , Angiology 4:59-100, 1953.Crossref 6. Pratt, G. H.: Arterial Varices—a Syndrome , Am. J. Surg. 77:456-460, 1949.Crossref 7. Pratt, G. H.: Surgical Treatment of Aneurysms, with a Discussion of Arterial Varices , Am. Heart J. 38:43-53, 1949.Crossref 8. Pratt, G. H.: Cardiovascular Surgery , Philadelphia, Lea & Febiger, 1954. 9. Pratt, G. H.: Surgical Management of Vascular Diseases , Philadelphia, Lea & Febiger, 1949. 10. Pratt, G. H.: The Pathogenesis and Early and Late Treatment of the Post-Thrombotic Syndrome (The Patient with the Postphlebitic Leg) , S. Clin. North America 33:1229-1244, 1953. 11. Pratt, G. H.: The Surgical Significance and Management of Pathologic Blood Clotting , Surg. Gynec. & Obst. 97:589-596, 1953. 12. Pratt, G. H.: Management of Varicose Veins , Pictoclinic (Ames Company) Vol. 3, No. (5) , 1957. 13. Pratt, G. H.: Thrombophlebitis and Thrombosis of Veins of the Extremities, Current Therapy , Philadelphia, W. B. Saunders Company, 1958, pp. 182-187. 14. Fontaine, R.: Venous Thrombosis and Its Sequelae , Surgery 41:6-25, 1957.
A.M.A. Archives Surgery – American Medical Association
Published: Jan 1, 1960
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