# A delayed venous repair strategy after penetrating vascular trauma

## TL;DR

A patient with severe leg artery and vein injuries was treated with a two-step approach, first stabilizing the patient and later repairing the vein, leading to good long-term results.

## Contribution

This case demonstrates that delayed venous repair after initial damage-control measures may reduce postoperative complications.

## Key findings

- Delayed interposition bypass grafts of the external iliac artery and vein resulted in good long-term outcomes.
- Postoperative venous thromboembolism did not prevent successful recovery.
- Staged venous repair may be a viable strategy in hemodynamically unstable patients.

## Abstract

We describe a patient with an external iliac artery and vein injury managed initially with arterial shunting and vein ligation because of hemodynamic instability. The patient underwent a delayed interposition bypass grafts of both external iliac artery and vein. Long-term outcomes were good despite development of postoperative venous thromboembolism. Although it is thought that venous ligation, often completed in a damage-control scenario, precludes venous repair, this case shows a staged approach to venous repair may decrease postoperative morbidity. Further investigation is needed to determine the role of delayed venous repair in improving outcomes.