title: Expanded polytetrafluoroethylene in external valvuloplasty for superficial or deep vein incompetence.
abstract: The authors evaluated the long-term safety of expanded polytetrafluoroethylene (ePTFE) implants used in external valvuloplasty for treatment of incompetence of the long saphenous and common and superficial femoral veins. During a 15-year period patients with superficial and/or deep venous disease and hypertension due to pure superficial or deep vein incompetence underwent an external valvuloplasty with ePTFE sutures, or an ePTFE cardiovascular patch placed as a sleeve around the incompetent vein segment, or an ePTFE tubular graft placed around the venous segment. Postoperative follow-up evaluations consisted of clinical examinations, high-resolution ultrasonography, and color duplex scanning, and a complete blood count performed at 1, 3 and 6 months, and repeated for at least 4 years, every 2 years after the procedure. A total of 101 patients (38 men and 63 women; mean [+/- sd] age, 44+/-12 years) underwent external valvuloplasty between January 1983 and December 1998; 82 of them completed the 4-year follow-up. Forty of the 82 patients had been operated on for superficial vein incompetence, 42 for deep vein incompetence. Overall, the mean follow-up time was 7.8+/-3.6 years (range, 4 to 13). There were no infections, thromboses,foreign-body reactions to the ePTFE implants, or other prosthesis-related complications requiring explantation. One granuloma (noninfected) developed in association with a tubular ePTFE implant around a long saphenous vein, but it did not necessitate implant removal. Seven patients required (at least after 4 years) a second procedure for recurrent or new venous incompetence. Therefore, in this observational study, ePTFE implants used to treat or correct venous incompetence were well tolerated on a long-term basis.
authors.affiliation: Cardiovascular Institute, Chieti University, Pescara, Italy. cardres@pe.abol.it
authors.forename: G
authors.initials: G
authors.lastname: Belcaro
authors.forename: A N
authors.initials: AN
authors.lastname: Nicolaides
authors.forename: B M
authors.initials: BM
authors.lastname: Errichi
authors.forename: L
authors.initials: L
authors.lastname: Incandela
authors.forename: M T
authors.initials: MT
authors.lastname: De Sanctis
authors.forename: G
authors.initials: G
authors.lastname: Laurora
authors.forename: A
authors.initials: A
authors.lastname: Ricci
mesh_terms: D000328:Adult; D005260:Female; D005268:Femoral Vein / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene / Q000627:therapeutic use*; D019919:Prosthesis Implantation; D012501:Saphenous Vein / Q000473:pathology* / Q000601:surgery; D013526:Surgical Mesh; D013537:Sutures; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D014689:Venous Insufficiency / Q000601:surgery*
chemical_list: D011138:Polytetrafluoroethylene