A delayed venous repair strategy after penetrating vascular trauma

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.