Intermediate-term results of angioscopy-assisted anterior valve sinus plication for primary deep venous insufficiency.
OBJECTIVE
The intermediate-term efficacy of angioscopy-assisted anterior valve sinus plication for primary deep venous insufficiency was evaluated.


METHODS
Twelve limbs in 11 patients had class 4 or higher disease on the SVS/ISCVS classification. Descending venography revealed grade-3 or 4-reflux in all limbs. The limbs were treated with angioscopy-assisted anterior valve sinus plication of the highest valve of the superficial femoral vein. Clinical evaluation and air plethysmography were performed at the final follow-up.


RESULTS
The mean follow-up was 38.4 months with a range of 24 to 48 months. Postoperative descending venography revealed significant improvement of the reflux of the superficial femoral vein. At the final follow-up, all patients reported relief of subjective symptoms. The ulcers healed and did not recur in the single limb with class-6 disease, the ulcers did not recur in four class-5 limbs, and there was a distinct clinical improvement with resolution of skin changes in the seven class-4 limbs. The venous filling index measured by air plethysmography was in a normal range in 8 of the 12 limbs.


CONCLUSIONS
Angioscopy-assisted anterior valve sinus plication may be a surgical technique that results in intermediate-term clinical and hemodynamic improvement in patients with primary deep venous insufficiency.
Nishibe
T
T
Division of Cardiovascular Surgery, Department of Cardiovascular Surgery, Fujita Health University, Toyoake, Japan.
Kudo
F
F
Miyazaki
K
K
Kondo
Y
Y
Koizumi
J
J
Dardik
A
A
Nishibe
M
M
D000328:Adult; D000800:Angioplasty, Balloon / Q000379:methods*; D017546:Angioscopy / Q000379:methods*; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D010991:Plethysmography; D013997:Time Factors; D016896:Treatment Outcome; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*