Clinical trials that have influenced the treatment of venous thromboembolism: A historical perspective

In 1950, Barritt and Jordan performed the first randomized trial demonstrat ing the efficacy of anticoagulant therapy in the treatment of venous thromb oembolism. Since then, important therapeutic advances have been made in the treatment of deep venous thrombosis and pulmonary embolism. This paper rev iews the important clinical trials involving anticoagulant therapy and vena caval interruption. The studies are discussed from a historical perspectiv e, and an attempt is made to analyze both the thought processes that prompt ed their design and the reasons why they changed practice.