Hemodynamics of canine femoral venous ligation: Significance in combined arterial and venous injuries

The hemodynamics of femoral venous ligation were studied in the canine hindlimb. Femoral arterial blood flow, femoral venous pressure, and peripheral resistance were measured immediately, 8, 24 and 72 hours after femoral venous ligation and compared with the opposite control hindlimb. Femoral arterial flow was significantly reduced immediately, 8 and 24 hours after venous ligation but returned to control levels 72 hours after ligation. Although the reduced arterial flow was adequate to maintain patency of end-to-end anastomoses of the femoral artery, this marginal flow may represent an ischemic insult to the injured extremity. Femoral venous pressure was markedly elevated immediately after ligation and remained significantly elevated 72 hours after ligation. Peripheral resistance was elevated immediately and eight hours after ligation but was not significantly different from control level 24 and 72 hours after ligation. The improvement in arterial flow associated with the reduction in venous pressure and peripheral resistance was presumably due to an improvement in venous drainage through collateral vessels. These hemodynamic effects may be more prolonged in the clinical setting and adversely affect limb survival. These data support the recommendation for repair of venous injuries of the lower extremity, particularly when associated with a major arterial injury.