Edgar Williams ParryBMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d4622 (Published 20 July 2011) Cite this as: BMJ 2011;343:d4622
- Averil Mansfield
Edgar Parry’s key legacies are in the emerging specialty of vascular surgery, which has developed from its traditional role in sympathectomy, varicose veins, and amputations. In the 1950s opportunities arose to repair and replace diseased blood vessels, and this was what Parry decided to pursue.
In 1952 about 12% of the 78% of hospital deaths that were investigated by postmortem examination involved pulmonary emboli, a worryingly high incidence, especially in apparently fit patients after operation. Working with Professors Milnes Walker and T F Hewer in Bristol, Parry observed that the massive pulmonary emboluses almost always occurred in patients older than 40 after an operation. There was substantially increased risk in malignancy. Anticoagulants had been prescribed only in half of these patients, and Parry recognised the paucity and therefore unreliability of the clinical signs of deep vein thrombosis.
Clots above the knee
He saw that thrombuses were often bilateral and that the more proximal the thrombus the greater the risk of embolism—for example, 70% in femoral vein thrombuses and 30% in calf thrombuses. He also saw that in 10 limbs out of 104, clots were above the knee but not …