Basic Current Evidence for the Use of Drugs to Both Prevent and Treat Patients with Venous Thrombosis and Pulmonary Embolism

  • C. V. Ruckley


This paper will largely be devoted to the role of platelet suppressant agents in the prophylaxis of venous thrombosis in surgical patients. It is worth pointing out, however, that the universal interest in prevention and in acute thrombosis sometimes obscures the fact that venous disease offers a number of other areas of therapeutic challenge. These include the prevention of recurring thrombotic and/or embolic episodes, the avoidance or the amelioration of the post-thrombotic syndrome — a largely neglected disorder — and the need to prevent thrombosis after venous reconstruction, perhaps the most difficult area of all. Whether agents which interfere with the interaction between blood cells and vessel wall have a part to play in any or all of these situations is as yet far from clear.


Pulmonary Embolism Deep Vein Thrombosis Venous Thrombosis Venous Thromboembolism Venous Thrombus 
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  1. Clagett, G. P., Brier, D. F., Rosoff, C. B., Schneider, P. B. & Saizman, E. W. (1974). Effect of aspirin on post-operative platelet kinetics and venous thrombosis. Surg. Forum, 25, 473–476.PubMedGoogle Scholar
  2. Cooke, E. D., Lloyd, M. J., Bowcock, S. A. & Pilcher, M. F. (1977). Intravenous lignocaine in prevention of deep venous thrombosis after elective hip surgery. Lancet, 2, 797–799.CrossRefPubMedGoogle Scholar
  3. Dechavanne, M, Ville, D., Viala, J. J., Kher, A., Faivre, J., Pousset, M. B. & Dejour, H. (1975). Controlled trial of platelet anti-aggregating agents and subcutaneous heparin in prevention of post-operative deep vein thrombosis in high risk patients. Haemostasis, 4, 94–100.PubMedGoogle Scholar
  4. Fossard, D. P., Friend, J. R., Field, E. S., Corrigan, T. P., Kakkar, V. V. & Flute, P. T. (1974). Fibrinolytic activity and post-operative deep vein thrombosis. Lancet, 1, 9–11.CrossRefPubMedGoogle Scholar
  5. French, J. E. (1965). The structure of natural and experimental thrombi. Ann. Roy. Coll. Surg. Eng., 36, 191–200.PubMedCentralPubMedGoogle Scholar
  6. Harris, W. H., Salzmann, E. W., Athanasoulis, C., Waltman, A. C., Baum, S. & de Sanctis, R. W. (1974). Comparison of warfarin, low-molecular-weight dextran, aspirin and subcutaneous heparin in prevention of venous thromboembolism following total hip replacement. J. Bone Joint Surg., 56, 1552–1562.PubMedGoogle Scholar
  7. Harris, W. H., Saizman, E. W., Athanasoulis, C. A., Waltman, A. C. & de Sanctis, R. W. (1977). Aspirin prophylaxis of venous thromboembolism after total hip replacement. N. Eng. J. Med., 297, 1246–8.CrossRefGoogle Scholar
  8. Hume, M., Donaldson, W. R. & Supprenant, J. (1978). Sex, aspirin and venous thrombosis. Orth. Clin. N. Am., 9, 761–767.Google Scholar
  9. Loew, D., Brocke, P., Simma, W., Vinazzer, H., Dienstl, E. & Boehme, K. (1977). Acetylsalicylic acid, low dose heparin and a combination of both substances in the prevention of post-operative thromboembolism. A double blind study. Thromb. Res., 11, 81–86.CrossRefPubMedGoogle Scholar
  10. Malone, P. C., Hamer, J. D. & Silver, I. A. (1979). Oxygen tension in venous valve pockets. Abstracts VII Int Congress on Thrombosis and Haemostasis. In Thrombosis and Haemostasis, pp. 230. Stuttgart: Schatlauer Verlag.Google Scholar
  11. Morris, G. K. & Mitchell, J. R. A. (1977). Preventing venous thromboembolism in elderly patients with hip fractures: studies of low-dose heparin, dipyridamole, aspirin and flurbiprofen. Brit. med. J., 1, 535–537.PubMedCentralCrossRefPubMedGoogle Scholar
  12. MRC Steering Committee (1972). Effect of aspirin on post-operative venous thrombosis. Lancet, 2, 441–444.Google Scholar
  13. Olson, P. S. (1974). Thrombus formation in the arterial and venous circulation in hypofibrinogenemic dogs. Eur. Surg. Res., 6, 176–182.CrossRefPubMedGoogle Scholar
  14. Olson, P. S., Lungquist, U. & Bergentz, S. E. (1974). Analysis of platelet, red cell and fibrin content in experimental arterial and venous thrombi. Thromb. Res., 5, 1–19.CrossRefPubMedGoogle Scholar
  15. Paterson, J. C. (1969). The pathology of venous thrombi. In Thrombosis. ed. Sherry, S., pp. 321, Washington D.C.: Nat. Acad. Sci.Google Scholar
  16. Renney, J. T. G., O’Sullivan, E. F. & Burke, P. E. (1976). Prevention of post-operative deep vein thrombosis with dipyridamole and aspirin. Brit. med. J., 1, 992–994.PubMedCentralCrossRefPubMedGoogle Scholar
  17. Rogers, P. H., Walsh, P. N., Marder, V. J., Bazak, G. C., Lachman, J. W., Ritchie, W. G. M., Oppenheimer, L. & Sherry, S. (1978). Controlled trial of low-dose heparin and sulphinpyrazone to prevent venous thromboembolism after operation on the hip. J. Bone int. Surg., 66, 758–762.Google Scholar
  18. Salzman, E. W. & Harris, W. H. (1976). Prevention of venous thromboembolism in orthopaedic patients. J. Bone int. Surg., 58, 903–913.Google Scholar
  19. Salzman, E. W., Harris, W. H. & de Sanctis, R. W. (1971). Reduction in venous thromboembolism by agents affecting platelet function. N. Eng. J. Med., 284, 1287–1292.CrossRefGoogle Scholar
  20. Schondorf, T. H. & Hey, D. (1976). Combined administration of low dose heparin and aspirin as prophylaxis of deep vein thrombosis after hip joint surgery. Haemostasis, 5, 250–256.PubMedGoogle Scholar
  21. Sevitt, S. (1974). Organization of valve pocket thrombi and the anomalies of double thrombi and valve cusp involvement. Brit. J. Surg., 61, 641–649.CrossRefPubMedGoogle Scholar
  22. Silvergleid, A. J., Bernstein, R., Burton, D. S., Tanner, J. B., Silverman, J. F. & Schrier, S. L. (1978). ASA-Dipyridamole prophylaxis in elective total hip replacement. Orthopedics, 1, 19–25.PubMedGoogle Scholar
  23. Smith, R. C., Duncanson, J., Ruckley, C. V., Webber, R. G., Allan, N. C., Dawes, J., Bolton, A. E., Hunter, W. M., Pepper, D. S. & Cash, J. D. (1978). β-Thromboglobulin and deep vein thrombosis. Thromb. Haemost., 39, 338–345.PubMedGoogle Scholar
  24. Stewart, G. J., Ritchie, W. G. M. & Lynch, P. R. (1974). Venous endothelial damage produced by massive sticking and emigration of leucocytes. Am. J. Path., 74, 507–521.PubMedCentralPubMedGoogle Scholar
  25. Welch, W. G. (1887). The structure of white thrombi. Trans. Path. Soc. Philadelphia, 13, 281–285.Google Scholar
  26. Wessler, S. (1955). Studies in intravascular coagulation III. The pathogenesis of serum induced venous thrombosis. J. clin. Invest., 34, 647–656.PubMedCentralCrossRefPubMedGoogle Scholar
  27. Wood, E. H., Prentice, C. R. M., McGrouther, D. A., Sinclair, J. & McNicol, G. P. (1973). Trial of aspirin and RA233 in prevention of post-operative deep vein thrombosis. Thromb. Diath. Haemorrh., 30, 18–23.PubMedGoogle Scholar
  28. Wu, A. & Mansfield, A. O. (1980). The morphological changes of the endothelium to venous stasis as observed under the scanning electron microscope. J. Cardiovas. Surg., 21, 193–196.Google Scholar

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© The contributors 1980

Authors and Affiliations

  • C. V. Ruckley
    • 1
  1. 1.The Royal InfirmaryEdinburghScotland

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