Outcome in the management of venous injury without arterial injury

Objective We retrospectively evaluated the outcome of venous repairs in patients who underwent operation. Method We report the management of 33 patients with venous injury without arterial injury. The mechanisms of injuries were gunshot wounds in 6 patients, stab wounds in 25, and blunt trauma in 2 patients. There were inferior caval vein injuries in 2 patients, azygos vein in 1, superior mesenteric vein in 1, external iliac vein in 4, common femoral vein in 5, superficial femoral vein in 16, and popliteal vein in 4. The management included lateral venorrhaphy in 2, venous patch angioplasty in 9, end to end anastomosis in 19, reversed saphen vein graft in 2, and ligation in 1 patient. To prevent venous thrombosis low molecular weight-dextran was used after venous repair. Results One patient with combined thoracic and abdominal injuries died 3 days after the operation. The remaning 32 patients survived. Color duplex sonography was performed in 6 patients with abdominal venous injuries following the operation, and revealed patent veins in all cases. Postoperative venography was performed 3 months or later in 25 patients with peripheric venous injures, 18 of whom had basically normal veins with functioning valves. In the remaining 7 patients, venography demonstrated venous thrombosis. Conclusion We suggest that the repair of venous injuries may be the procedure of choice rather than ligation even in patients with associated visceral injuries.