Long-term patency of venous repairs demonstrated by venography

Indications for venous reconstruction after traumatic injury are controversial, partly because of uncertainty of continued patency. We found no reports in the literature of truly long-term results after venous reconstruction. For clarification of this issue, we reviewed femoral venous injuries in a civilian metropolital population over a 20-year period. There were 31 patients with penetrating femoral venous injuries. Twenty-four patients underwent reconstruction. A search for these patients years after reconstruction located only five patients with six reconstructions. Followup venography at 6 to 20 years demonstrated venous patency and functional valves with asymptomatic patients and no clinical evidence of venous insufficiency in all cases excluding a single 1962 repair with a Teflon graft. This study then supports reconstruction rather than ligation after venous trauma. Although small, this series appears to be the only known report of truly long-term results following venous reconstruction.