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Venous ligation versus venous repair: does the procedure impact venous thromboembolism risk?

BACKGROUND: Traumatic lower extremity venous injuries are most commonly managed with either a vein ligation or repair procedure. Venous injuries are associated with an increased risk of developing venous thromboembolisms (VTE), but little is understood with regard to how specific surgical treatments...

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Autores principales: Farrell, Michael Steven, Knudson, M Margaret, Stein, Deborah M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7978278/
https://www.ncbi.nlm.nih.gov/pubmed/33791437
http://dx.doi.org/10.1136/tsaco-2021-000687
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author Farrell, Michael Steven
Knudson, M Margaret
Stein, Deborah M
author_facet Farrell, Michael Steven
Knudson, M Margaret
Stein, Deborah M
author_sort Farrell, Michael Steven
collection PubMed
description BACKGROUND: Traumatic lower extremity venous injuries are most commonly managed with either a vein ligation or repair procedure. Venous injuries are associated with an increased risk of developing venous thromboembolisms (VTE), but little is understood with regard to how specific surgical treatments may impact the risk of developing either a deep vein thrombosis (DVT) or a pulmonary embolism (PE). In this study of lower extremity venous injuries, we hypothesized that venous ligation would be associated with an increased risk of DVT but a lower risk of PE when compared with venous repair. METHODS: Patients were identified from the National Trauma Data Bank (2008 to 2014) with at least one iliac, femoral, popliteal, or tibial venous injury and who received either a vein ligation or repair. The patients were then compared based on the type of procedure and the location of the injury to assess the risk of DVT and PE between the groups. RESULTS: A total of 1214 patients were identified. There was no difference between patients who received a vein ligation versus a repair with respect to age, injury severity score, or initial systolic blood pressure. There was no difference in the odds of developing either a DVT or PE between patients who were treated with vein ligation versus repair. There was also no difference in VTE rates when stratified by the location of the injury. CONCLUSIONS: In individuals with lower extremity venous injuries, there is no difference in the rate of DVT or PE complications when comparing venous repair and ligation procedures. The role of anticoagulation remains to be elucidated following operative treatment. LEVEL OF EVIDENCE: Therapeutic/Care Management, Level IV.
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spelling pubmed-79782782021-03-30 Venous ligation versus venous repair: does the procedure impact venous thromboembolism risk? Farrell, Michael Steven Knudson, M Margaret Stein, Deborah M Trauma Surg Acute Care Open Original Research BACKGROUND: Traumatic lower extremity venous injuries are most commonly managed with either a vein ligation or repair procedure. Venous injuries are associated with an increased risk of developing venous thromboembolisms (VTE), but little is understood with regard to how specific surgical treatments may impact the risk of developing either a deep vein thrombosis (DVT) or a pulmonary embolism (PE). In this study of lower extremity venous injuries, we hypothesized that venous ligation would be associated with an increased risk of DVT but a lower risk of PE when compared with venous repair. METHODS: Patients were identified from the National Trauma Data Bank (2008 to 2014) with at least one iliac, femoral, popliteal, or tibial venous injury and who received either a vein ligation or repair. The patients were then compared based on the type of procedure and the location of the injury to assess the risk of DVT and PE between the groups. RESULTS: A total of 1214 patients were identified. There was no difference between patients who received a vein ligation versus a repair with respect to age, injury severity score, or initial systolic blood pressure. There was no difference in the odds of developing either a DVT or PE between patients who were treated with vein ligation versus repair. There was also no difference in VTE rates when stratified by the location of the injury. CONCLUSIONS: In individuals with lower extremity venous injuries, there is no difference in the rate of DVT or PE complications when comparing venous repair and ligation procedures. The role of anticoagulation remains to be elucidated following operative treatment. LEVEL OF EVIDENCE: Therapeutic/Care Management, Level IV. BMJ Publishing Group 2021-03-18 /pmc/articles/PMC7978278/ /pubmed/33791437 http://dx.doi.org/10.1136/tsaco-2021-000687 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Original Research
Farrell, Michael Steven
Knudson, M Margaret
Stein, Deborah M
Venous ligation versus venous repair: does the procedure impact venous thromboembolism risk?
title Venous ligation versus venous repair: does the procedure impact venous thromboembolism risk?
title_full Venous ligation versus venous repair: does the procedure impact venous thromboembolism risk?
title_fullStr Venous ligation versus venous repair: does the procedure impact venous thromboembolism risk?
title_full_unstemmed Venous ligation versus venous repair: does the procedure impact venous thromboembolism risk?
title_short Venous ligation versus venous repair: does the procedure impact venous thromboembolism risk?
title_sort venous ligation versus venous repair: does the procedure impact venous thromboembolism risk?
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7978278/
https://www.ncbi.nlm.nih.gov/pubmed/33791437
http://dx.doi.org/10.1136/tsaco-2021-000687
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