Vascular trauma during surgery for varicose veins of lower limbs

Abstract

Iatrogenic injuries of major blood vessels although are rare, represent a real disaster during intervention for varicose veins of lower limbs. We report two cases of vascular trauma during varicose vein surgery: one patient with combined injury of femoral artery and common femoral vein and one case of isolated laceration of the common femoral vein. Injuries were diagnosed intraoperatively and vascular repair was performed. Mortality, limb loss or development of postthrombotic syndrome were not registered. Th e incidence of iatrogenic vascular trauma in varicose veins surgery during ten years interval was 0,15% in our prospective series. Review of the literature demonstrates that trauma of deep veins during crossectomy and stripping may be life-threatening but arterial injuries are associated with high rate of amputations – up to 30%. Stripping of lower limb arteries represents the most severe type of injury. Prompt implication of vascular specialist in the procedure in case of trauma of major blood vessels plays a critical role.