Hobson RW 2nd, Yeager RA, Lynch TG, Lee BC, Jain K, Jamil Z, Padberg FT Jr.
Femoral venous trauma: techniques for surgical management and early results.
Am J Surg 1983 Aug;146(2):220-4

During a 4 year period (1979 through 1983), 181 major arterial (69 percent) and
81 venous (31 percent) injuries were treated surgically. Of the venous injuries,
24 (30 percent) involved the femoral veins (9 common femoral, 15 superficial
femoral). Management of these femoral venous injuries included lateral
venorrhaphy in 10 cases (42 percent), venous patch angioplasty in 5 cases (21
percent), end-to-end anastomosis in 4 cases (17 percent), interposition
autogenous saphenous vein grafts in 3 patients (12 percent), and ligation in 2
cases (8 percent). One case that included common femoral venous ligation and one
that included a failed interposition saphenous vein graft in the superficial
femoral vein subsequently were managed with in situ saphenous vein bypass. For
one interposition saphenous vein graft repair of the common femoral vein we
utilized the spiral vein graft technique. Excluding one early death from
associated injuries and one superficial femoral venous injury managed by ligation
without postoperative complications, 17 of 23 (74 percent) femoral venous repairs
were judged patent postoperatively (13 confirmed by venography and 4 by
noninvasive testing). The adjuvant use of intermittent pneumatic calf compression
and low molecular weight dextran appears to have been beneficial in maintaining
patency of the femoral venous repairs. Early clinical follow-up demonstrated the
presence of edema in 6 of 8 cases (75 percent) initially treated by ligation or
complicated by postoperative occlusion. Early postoperative edema, present in 4
of 17 (24 percent) patients with patent venous repairs, had resolved by the time
of discharge. We recommend routine repair of femoral venous injuries. When
significant edema or ischemia develop following obligatory venous ligation or
postoperative occlusion of a venous repair, revision or venous bypass should be
considered.