The effect of vein repair on the risk of venous thromboembolic events: A review of more than 100 traumatic military venous injuries

Abstract

In the largest review of military venous trauma in more than three decades, we found no difference in the incidence of venous thromboembolic complications between venous injuries managed by open repair vs ligation. Blast injuries of the extremities have caused most of the venous injuries. Ligation is the most common modality of treatment in combat zones. Long-term morbidity associated with venous injuries and their management will be assessed in future follow-up studies.

Effect of temporary shunting on extremity vascular injury: An outcome analysis from the Global War on Terror vascular injury initiative

“…[5][6]16 Moreover, there is no appreciable increased risk of thromboembolism with venous repair, providing further evidence supporting this strategy. 15 In our cohort, several individuals had vein disruption shunted early in the course of injury. This may have affected even- tual outcome, but it is difficult to discern and not a focus of this study.…”

“…Individual registries in OIF have reported early amputation rates of 5% to 10% [5][6][7][8] as opposed to 50% in World War II 9 and 10% to 20% for Korea and Vietnam. [10][11][12][13][14] Yet, current in-theater descriptions of TVS, 2-4 venous injury repair, 5,15,16 and other employed treatment maneuvers allude only to technical considerations and immediate, or early limb salvage and fail to include long term outcomes or risk analysis.…”

Challenges encountered and lessons learnt from venous injuries at Sri Lankan combat theatres

“…In modern combat theatres (Iraq and Afghanistan data) high venous repair rates were maintained (82% and 61%),7 8 but was 36% in Sri Lankan war theatres. The low rate of venous repair in this current analysis was due to the number of cases that had to be managed by the surgeons at a particular given time in this resource poor setting.…”

Lower Extremity Vascular Trauma

“…Importantly, that experienced showed no increased incidence of venous thrombosis or pulmonary thrombembolism in the cohort of patients undergoing extremity vein repair. 33 Extremity vein injury in the multiply injured patient who is in poor physiologic condition should be ligated. Similarly, complex extremity vein injuries that require long segment interposition grafting or use of synthetic conduits should be managed with ligation in most instances.…”