[Theory and practice of hemodynamic treatment of deep venous insufficiency caused by valve absence].
HDDVI is a form of surgical treatment which, using a series of selective ligatures, is aimed at curing deep venous insufficiency due to valve absence. There are two fundamental principles: an incompetent vein ensures no venous return in standing position and is the site of reverse circulation; this ineffective vein develops a collateral circulation because of the increased pressure which it produces. However, this parallel circulation is in fact neutralised by the diseased vein which forms a retrograde shunt. Section ligatures are suggested taking into account single main veins with minimal collaterals (popliteal vein, femoral vein, external iliac vein) for which patency is essential. This novel theory is based upon physical, and anatomical and functional clinical arguments. The strategy is discussed in terms of the hemodynamic map of the deep veins obtained by orthostatic duplex Doppler. Confirmation that the theory is well-founded appears to be provided by the first cases treated.
Rinieri
J
J
Hôpital Henri Mondor, Creteil.
Mellière
D
D
D003097:Collateral Circulation; D006439:Hemodynamics; D006801:Humans; D014463:Ultrasonography; D014680:Veins / Q000601:surgery; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*
Théorie et pratique de la cure hémodynamique de l'insuffisance veineuse profonde par dévalvulation.