Endoscopically directed external support of femoral vein valves.
BACKGROUND
This study investigated the optimization of indications to external valve support using the Vedensky Spiral for primary deep venous reflux based on the femoral vein proximal (ostial) valve anatomy type.


METHODS
The external Vedensky Spiral was used for correction of valvular insufficiency in 28 extremities of 24 patients (18 women, 6 men) during 1998 to 2002. Patients were a mean age of 54.6 years (range, 32-76 years). The clinical manifestation was C(4) in 10 limbs and C(5) in 18 limbs. Primary axial deep reflux was present in all 28 extremities, and axial superficial reflux was also present in 26. Duplex scanning and descending phlebography were used to estimate the functional condition of the deep vein valves. Fibrophleboscopy intraoperatively to study the anatomic status of the femoral vein valves and for checking the repaired valve function was used.


RESULTS
Phleboscopy showed the following anatomy of ostial valves of the femoral vein: 16 valves had wide separation of cusps, 11 had elongation of cusps, and one had a monocusp. The competence of femoral vein ostial valves was completely restituted in all cases with wide separation of cusps. Multiple corrections were performed in cases with incomplete competence of the ostial valve (valve with elongation of cusps or monocusp).


CONCLUSIONS
External valve support by the Vedensky Spiral is an effective and simple method of correction of incompetent femoral vein valves in limbs with primary deep venous reflux. The technical success of the intervention depends on the type of valve insufficiency and the correct choice of spiral diameter.
Makhatilov
Gadzhi
G
Department of Cardiovascular Surgery, Dagestan State Medical Academy, Makhachkala, Russian Federation.
Askerkhanov
Gamid
G
Kazakmurzaev
Medjid Arsenovich
MA
Ismailov
Ismail
I
D000328:Adult; D000368:Aged; D004724:Endoscopy; D004867:Equipment Design; D005260:Female; D005268:Femoral Vein / Q000473:pathology / Q000601:surgery*; D005336:Fiber Optic Technology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D014689:Venous Insufficiency / Q000473:pathology / Q000601:surgery*; D055422:Venous Valves / Q000473:pathology / Q000601:surgery*