External banding valvuloplasty of the superficial femoral vein in the treatment of primary deep valvular incompetence.
Primary deep venous insufficiency (PDVI) represents an important cause of chronic venous insufficiency (CVI). The clinical picture is generally related to a congenital weakness of the vein wall at the level of the valvular ring which may dilate its diameter with consequent lengthening and prolapse of the valvular cusps. However, in an initial stage of PDVI the leaflets are normally formed and may undergo restorative surgery. In this condition an external banding valvuloplasty (EBV) with a Dacron sleeve around the incompetent valve may restore the competence. The authors report 54 cases of superficial femoral vein EBV performed over a period of 1986 to 1991. The patients were affected by signs of CVI and/or relapsing, complicated or atypical varices in which descending venography showed a grade II, III or IV primary deep reflux. In a mean follow-up of 38 months (4 to 63 months) deep reflux had disappeared in 41 patients (76%), had significantly decreased in 8 (14.8%) and was completely unmodified in 5 (9.2%). According to the experience of other authors, these results suggest the therapeutic validity of EBV in the initial stage of PDVI.
Camilli
S
S
Department of Vascular Surgery, Istituto Dermopatico dell'Immacolata, Rome, Italy.
Guarnera
G
G
D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010690:Phlebography; D011089:Polydeoxyribonucleotides / Q000627:therapeutic use; D011183:Postoperative Complications; D016896:Treatment Outcome; D014689:Venous Insufficiency / Q000175:diagnosis / Q000628:therapy*
D005343:Fibrinolytic Agents; D011089:Polydeoxyribonucleotides; C036901:defibrotide; D006493:Heparin