title: Valve reconstruction procedures for nonobstructive venous insufficiency: rationale, techniques, and results in 107 procedures with two- to eight-year follow-up.
abstract: Among 211 limbs with nonobstructive chronic venous insufficiency, valve reflux of the deep system was the predominant (more than 70%) pathologic condition. Superficial venous or perforator incompetence when present invariably occurred in combination with valve reflux of the deep veins, suggesting that the latter is a common denominator for symptom production. Single level-single system reflux was only occasionally symptomatic (10%), whereas the incidence of single level-multisystem reflux (25%) and multilevel-multisystem reflux (65%) in symptomatic limbs was much higher. Our experience with 107 venous valve reconstructions with a 2- to 8-year follow-up is described. Different techniques of valve reconstruction employed are detailed. The most common pathologic feature is a redundant valve with malcoaptation probably of nonthrombotic origin. Valsalva foot venous pressure elevation is a useful hemodynamic technique for assessing surgical results. Valvuloplasty may be superior to other reconstruction techniques in relieving symptoms of stasis, including stasis ulceration.
mesh_terms: D001367:Axillary Vein / Q000601:surgery; D001807:Blood Vessel Prosthesis; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D008220:Lymphography; D008722:Methods; D010690:Phlebography; D011093:Polyethylene Terephthalates; D011183:Postoperative Complications; D013997:Time Factors; D014680:Veins / Q000601:surgery*; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*
chemical_list: D011093:Polyethylene Terephthalates