RESULTS OF VASCULAR REPAIR IN TRAUMA OF T HE FEMORAL AND ILIAC VEINS AND THE INFERIOR VENA-CAVA

We examined the records of 12 patients operated for lesions of the inf erior vena cava, the iliac vein, or the common femoral vein were exami ned. The results of venous grafts, treatment of the lesions of the pos terior inferior vena cava or the supra hepatic vena cava and the perme ability after repair of these large vessels was studied. Treatment inc luded simple suture (n = 9), venous patch (lateral iliac vein, n = 1), and venous autografts (common femoral veins, n = 2). For 3 lesions of the posterior or supra-hepatic inferior vena cava, haemostasis was ob tain by double clamping (n = 2) or four-way clamping (n = 1) with righ t hepatectomy. In 9 cases, the patients were followed-up for a mean of 59 months. Morphologic exploration with phlebography (n = 1) or echo- Doppler examination (n = 7) was performed during the follow-up period. There were no post-operative deaths. There were no functional sequell ae affecting the lower limbs. In one case, the echo-Doppler examinatio n revealed repermeabilization of a thrombosed lateral iliac vein after simple suture. Lesion repair of large diameter veins with autografts using the internal jugular or internal saphenous vein gave good result s. Haemostais of posterior or supra-hepatic lesions to the inferior ve na cava was obtained with clamping. In cases with associated hepatic i nvolvement, haemostasis was controlled with a four-way clamp and trans -hepatic access or digitoclasty. Long-term permeability of venous repa ir was good.