The history and historical treatments of deep vein thrombosis.
J Thromb Haemost. 2013 Jan 8;
Authors: Galanaud JP, Laroche JP, Righini M
Deep-vein thrombosis (DVT) is a common disease. However, unlike varicose veins that have been depicted since antiquity in art and literature, its description was more recent in the history of medicine. The first well-documented case of DVT was reported during the Middle Ages: in 1271 Raoul developed an unilateral edema in the ankle which then extended to the leg. The number of reported DVT cases steadily increased thereafter, in particular in pregnant and post-partum women. During the first half of the 20(th) century, well before the discovery of anticoagulants, many therapeutic approaches were used, and arose from the pathological hypotheses that prevailed at their time. Despite the development of anticoagulants and the fact they were thought to dramatically decrease DVT mortality, numerous complementary treatments have also been developed during the last fifty years: they include vena cava clips and surgical thrombectomy, and are intended to decrease mortality or to prevent late complications. Most of these treatments have now been abandoned and even forgotten. In this review, we recall also the discovery and the use of anti-vitamin K and heparin, which have been the mainstay of treatment for decades. We also bring some perspective to historical aspects of this disease and its treatment, notably regarding elastic compression and early mobilization, but also abandoned and complementary treatments. In the changing times of DVT treatment, mainly marked by the arrival of new oral anticoagulants, efforts of physicians through the ages to treat this common disease are a beautiful example of the history of knowledge. © 2013 International Society on Thrombosis and Haemostasis.
PMID: 23297815 [PubMed - as supplied by publisher]