Venous trauma. Successful venous reconstruction remains an interesting challenge

It has now been established, both clinically and experimentally, that ligation of some injured major veins can produce deleterious effects, particularly in the lower extremities. Successful venous reconstruction has been performed despite limitations and a number of technical problems. Fears of an increased incidence of thrombophlebitis and pulmonary embolism after attempted venous repair have also been refuted. The increased incidence of residual edema after lower extremity venous ligation has been emphasized. Documentation of additional experience in the civilian community in managing venous injuries is needed. Maintaining patency in a venous repair, with or without an assortment of adjunctive measures, remains a challenge for the future. Identification of the "ideal conduit" for segmental venous replacement or bypass continues to elude vascular surgeons.