Ligation of the Inferior Vena Cava

THE UNDESIRABLE sequelae to inferior vena caval ligation have been studied and reported by several observers * and these sequelae contribute significantly to a general reluctance on the part of physicians to apply this effective technique as broadly as might otherwise be indicated. Several reports have been pessimistic about these sequelae of caval ligation,^2,3,29 and have led investigators to search for alternative methods such as temporary and partial ligature techniques.^7,16,17 Recent interest has centered about plicative and sieve-construction techniques to lessen these sequelae.^9,30 Other reports are more optimistic,^18-22,28 and several have observed so few and minimal complications after vena cava ligation that they envision no further practical refinements in technique.¹⁴

The observation of minimal early edema and the subsequent improvement for many months after caval ligation among our patients suggested continuing vascular adjustment to ligation over a period of years and prompted a review of our