Femoral venous trauma: Techniques for surgical management and early results

Robert W. Hobson, Richard A. Yeager, Thomas G. Lynch, Bing C. Lee, Krishna Jain, Zafar Jamil, Frank T. Padberg Jr.

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Abstract

During a 4 year period (1979 through 1983), 181 major arterial (69 percent) and 81 venous (31 percent) injuries were treated surgically. Of the venous injuries, 24 (30 percent) involved the femoral veins (9 common femoral, 15 superficial femoral). Management of these femoral venous injuries included lateral venorrhaphy in 10 cases (42 percent), venous patch angioplasty in 5 cases (21 percent), end-to-end anastomosis in 4 cases (17 percent), interposition autogenous saphenous vein grafts in 3 patients (12 percent), and ligation in 2 cases (8 percent). One case that included common femoral venous ligation and one that included a failed interposition saphenous vein graft in the superficial femoral vein subsequently were managed with in situ saphenous vein bypass. For one interposition saphenous vein graft repair of the common femoral vein we utilized the spiral vein graft technique. Excluding one early death from associated injuries and one superficial femoral venous injury managed by ligation without postoperative complications, 17 of 23 (74 percent) femoral venous repairs were judged patent postoperatively (13 confirmed by venography and 4 by noninvasive testing). The adjuvant use of intermittent pneumatic calf compression and low molecular weight dextran appears to have been beneficial in maintaining patency of the femoral venous repairs. Early clinical follow-up demonstrated the presence of edema in 6 of 8 cases (75 percent) initially treated by ligation or complicated by postoperative occlusion. Early postoperative edema, present in 4 of 17 (24 percent) patients with patent venous repairs, had resolved by the time of discharge. We recommend routine repair of femoral venous injuries. When significant edema or ischemia develop following obligatory venous ligation or postoperative occlusion of a venous repair, revision or venous bypass should be considered.

Original languageEnglish (US)
Pages (from-to)220-224
Number of pages5
JournalThe American Journal of Surgery
Volume146
Issue number2
DOIs
Publication statusPublished - Aug 1983

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ASJC Scopus subject areas

  • Surgery

Cite this

Hobson, R. W., Yeager, R. A., Lynch, T. G., Lee, B. C., Jain, K., Jamil, Z., & T. Padberg Jr., F. (1983). Femoral venous trauma: Techniques for surgical management and early results. The American Journal of Surgery, 146(2), 220-224. https://doi.org/10.1016/0002-9610(83)90377-X