Abstract
Popliteal vascular trauma continues to be associated with a relatively high morbidity rate when compared to other major vascular injuries in extremities. There is continuing controversy regarding the management of popliteal venous injuries. The advocates of ligation of injured veins have postulated that there is an increased incidence in thrombophlebitis and pulmonary embolism associated with attempted venous repair. There is a paucity of valid statistics supporting either side of this controversy. Clinical experience documented in the Vietnam Vascular Registry and experimental work at Walter Reed Army Institute of Research have supported our more aggressive approach for venous repair. This study evaluates the management of 110 injured popliteal veins without associated popliteal arterial trauma. Nearly an equal number were ligated and repaired. Thrombophlebitis and pulmonary embolism were not significant complications in this series. The only pulmonary embolus occurred after ligation of an injured popliteal vein. However, there was a significant increase in edema of the involved extremity following ligation, 50.9% compared to 13.2% after repair.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Rich N. M., Baugh J. H., Hughes C. W. Acute arterial injuries in Vietnam: 1,000 cases. J Trauma. 1970 May;10(5):359–369. doi: 10.1097/00005373-197005000-00001. [DOI] [PubMed] [Google Scholar]
- Rich N. M., Baugh J. H., Hughes C. W. Popliteal artery injuries in Vietnam. Am J Surg. 1969 Oct;118(4):531–534. doi: 10.1016/0002-9610(69)90176-7. [DOI] [PubMed] [Google Scholar]
- Rich N. M., Hobson R. W., 2nd, Wright C. B., Fedde C. W. Repair of lower extremity venous trauma: a more aggressive approach required. J Trauma. 1974 Aug;14(8):639–652. doi: 10.1097/00005373-197408000-00002. [DOI] [PubMed] [Google Scholar]
- Rich N. M., Hughes C. W., Baugh J. H. Management of venous injuries. Ann Surg. 1970 May;171(5):724–730. doi: 10.1097/00000658-197005000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rich N. M., Hughes C. W. Vietnam vascular registry: a preliminary report. Surgery. 1969 Jan;65(1):218–226. [PubMed] [Google Scholar]
- Rich N. M., Jarstfer B. S., Geer T. M. Popliteal artery repair failure: causes and possible prevention. J Cardiovasc Surg (Torino) 1974 May-Jun;15(3):340–351. [PubMed] [Google Scholar]
- Rich N. M., Sullivan W. G. Clinical recanalization of an autogenous vein graft in the popliteal vein. J Trauma. 1972 Oct;12(10):919–920. doi: 10.1097/00005373-197210000-00016. [DOI] [PubMed] [Google Scholar]
- Sullivan W. G., Thornton F. H., Baker L. H., LaPlante E. S., Cohen A. Early influence of popliteal vein repair in the treatment of popliteal vessel injuries. Am J Surg. 1971 Oct;122(4):528–531. doi: 10.1016/0002-9610(71)90481-8. [DOI] [PubMed] [Google Scholar]