Management of Venous Injuries

Tactical Surgical Intervention With Temporary Shunting of Peripheral Vascular Trauma Sustained During Operation Iraqi Freedom: One Unit??s Experience

“…11,15,17,20 -22 Additionally, although the majority of civilian peripheral venous injuries appear to be adequately managed by ligation, [23][24][25][26] the greater soft tissue and collateral venous loss seen in a high percentage of military extremity injuries appears to warrant attempt at venous reconstruction unless ongoing hemodynamic insta- The Journal of TRAUMA Injury, Infection, and Critical Care bility precludes it. 20,27,28 TVS of complex peripheral venous injuries helps facilitate this subsequent venous reconstruction. We consequently advocate shunting of any major venous injury not amenable to venorrhaphy whenever necessary to preserve major venous outflow from the limb, unless the patient has significant ongoing systemic instability.…”

8.4 Penetrating injuries of the abdominal inferior vena cava

“…Primary repair of the IVC injury is recommended, even if the luminal diameter is compromised (10). The fear of pulmonary emboli originating from a partially stenosed vein has not been confirmed by clinical experience (18). In our study there was a 5% incidence of pulmonary emboli and 10% incidence of thrombosis alone in those patients who underwent lateral venorrhaphy.…”

Popliteal Arteriovenous Fistula Due to a Gunshot Injury

“…18 Reconstructive surgery helps to re-establish the anatomic continuity of the vessels by lateral suture or « patch » of the walls, using a termino-terminal anastomosis or bypass. 5,19 Repair of the vein is essential and should not be neglected, at the risk of the development of distal venous insufficiency. 20 After controlling the feeding vessels, the fistula could be controlled.…”