Autogenous venous interposition grafts in repair of major venous injuries

1) This review of 51 former Vietnam casualties who had lower extremity venous injuries repaired using autogenous interposition venous grafts is the largest series of this type of venous repair to be reported. Nevertheless, additional information is needed, including more extensive phlebographic documentation of the current status of venous reconstructions. 2) The results of these venous repairs performed by essentially a different surgical team in every case are encouraging. Only one patient, or 2.0% of the total, developed thrombophlebitis in the postoperative period and this was transitory in nature. No patients developed pulmonary embolism. There was no edema in the postoperative period in 66.6% of the total. During the longterm followup, only six patients, or 11.8%, had residual edema. This is in marked contrast to a similar number of patients followed in the Registry who had ligation of popliteal veins following trauma with persistent edema in 50.9%. 3) Although this study remains incomplete, the favorable data should stimulate interest in performing additional repair of major lower extremity venous injuries utilizing autogenous venous grafts. Expanded experimental and clinical research is needed to define a readily available conduit of variable sizes which can be utilized successfully in reconstruction of the low-flow venous system.