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Sede
Social
Colegio Oficial
de Médicos
de Barcelona
Paseo de la Bonanova, 47
08017 Barcelona
Telf.: 93 863 02 38
Fax: 93 863 05 58
secretariaseacv@telefonica.net |
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Lunes, 23 de Enero de 2012
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| Publicación
Española del Mes Nº 14 |
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Son las 01:40:11 horas del 5-2-2012 |
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Archivo PDF
(145 KB)
Femoral Vein Injury and Transposition Techniques: A New Approach to
Venous Reconstruction in the Setting of Trauma.
Lozano, Francisco S. MD, PhD, FACS; Estevan, Maria C. MD, PhD; Gónzalez Porras,
José R. MD, PhD.
J Trauma. 2009 Oct;67(4):E118-20.
Services of Vascular Surgery, Clinic Hospital, University of Salamanca, School of Medicine,
Salamanca, Spain. lozano@usal.es.
Factor de Impacto : 2.342.
Femoral vein (FV) injury is infrequent but potentially serious. Venous repair is the procedure of choice and
multiple technical options are performed. This article describes a novel venous reconstruction technique of
transposition of the injured FV into the deep femoral vein (DFV) system. Two men, 26 years and 32 years
old, were evaluated after suffering penetrating wounds to the inguinal region, resulting in proximal FV
injuries. Both the patients were treated with a lateral venorraphy of the common FV and transposition of
the FV to DFV (end-to-side anastomosis). Venous thrombectomy was not required; intravenous
unfractionated heparin and local acting heparin were administered during surgery. Low molecular weight
heparin therapy was routinely administered before intervention in combination with elastic compression
stockings. Duplex ultrasound at 1 month and 6 months after the injury demonstrated patency and luminal
integrity of the involved vein in both the patients. Clinical follow-up without duplex at 12 months and 18
months revealed no evidence of chronic venous insufficiency. In instances of penetrating injury to the
proximal FV, transposition to the DFV represents a novel and effective alternative to establishing venous
outflow from the extremity. This technique is relatively simple and presents good permeability in the
medium term. However, possible and often tolerated ligation of penetrating FV injuries should be
considered a last option.
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