Abstract
Purpose
The aim of this study was to evaluate different repair methods of popliteal vein injuries,
and to assess the relationship between early patency and surgical outcome.
Methods
Thirty patients with popliteal vein injuries underwent surgical repair procedure at
our hospital from March 2000 to April 2010. Patients who were haemodynamically unstable
and those with massive bleeding from limb wounds were taken directly to the operating
room. Stable patients underwent preoperative colour-flow duplex ultrasonography (CFDU).
Results
Our study group consisted of 26 males and 4 females, ranging in age from 17 to 60
years with a mean age of 25.3 ± 5.9 years. The mechanism of trauma was penetrating in 27 patients and blunt in the
remaining 3 patients. Treatment included primary venous repair in 11 cases, end-to-end
anastomosis in 8, interposition vein graft in 10, and interposition polytetrafluoroethylene
(PTFE) graft in 1. There were 26 patients with associated arterial injury, of which
4 cases had primary repair, 9 had end-to-end anastomosis, 11 had saphenous vein graft
interposition, and 2 had PTFE graft interposition. Associated bone fracture was seen
in 6 patients. There were no deaths. One patient required a below-knee amputation.
Postoperative CFDU revealed thrombosed venous repair in 7 cases without any sequelae.
Conclusion
Popliteal venous injuries can be repaired with minimal downside and a good early patency
rate. Additionally, transient venous patency allows for establishment of venous and
lymphatic collateralisation. Alternatively, venous ligation should be considered only
in unstable patients who refuse blood transfusion (Jehovah's witnesses). In these
victims, adjuvant management may be required such as the use of fasciotomy and anticoagulation
treatment.
Keywords
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Article info
Publication history
Accepted:
January 17,
2011
Identification
Copyright
© 2011 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
