Semin intervent Radiol 2005; 22(3): 225-232
DOI: 10.1055/s-2005-921956
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Percutaneous Therapy for Deep Vein Reflux

Dusan Pavcnik1 , John Kaufman1 , Lindsay Machan2 , Barry Uchida1 , Frederick S. Keller1 , Josef Rösch1
  • 1Dotter Interventional Institute, Oregon Health Sciences University, Portland, Oregon
  • 2Department of Radiology, University of British Columbia Hospital, Vancouver, British Columbia
Further Information

Publication History

Publication Date:
27 October 2005 (online)

ABSTRACT

At present, there are no widely accepted surgical or percutaneous treatment options for chronic venous insufficiency of the deep venous system. The small intestinal submucosa square stent bicuspid venous valve (BVV) has shown the most promising results of artificial venous valves developed to date. In experimental long-term studies in sheep jugular veins, 88% of implanted valves exhibited good function; 12% had decreased function related to valve tilting, of which only 4% had partial thrombosis. BVVs were also placed in three patients and have remained patent without thrombosis or other complications since 2002. At present, 3 years after BVV placement, symptoms in two patients are decreased. Proper sizing and proper placement of the valves were critical to their function. To eliminate occasional tilting of the original BVV, a second-generation BVV has been developed and tested.

REFERENCES

  • 1 Dotter C T. Interventional radiology: review of an emerging field.  Semin Roentgenol. 1981;  16 7-12
  • 2 Uflacker R. Percutaneously introduced artificial venous valve: experimental use in pigs. The 1993 Annual Meeting of the Western Angiographic & Interventional Society; September 29-October 3, 1993 Portland, Oregon; 1993 30
  • 3 Thorpe P E, Osse F J, Correa L O. The valve-stent: development of a percutaneous prosthesis for treatment of valvular insufficiency. The 12th Annual meeting of the American Venous Forum; February 3-6, 2000 Phoenix, Arizona; 2000 82
  • 4 Pavcnik D, Uchida B T, Timmermans H A, Keller F S, Rösch J, Keller F S. Aortic and venous valve for percutaneous placement.  Min Invas Ther Allied Technol. 2000;  9 287-292
  • 5 Gomez-Jorge J, Venbrux A C, Magee C. Percutaneous development of a valved bovine jugular vein in the swine venous system: a potential treatment for venous insufficiency.  J Vasc Interv Radiol. 2000;  11 931-936
  • 6 Pavcnik D, Uchida B T, Timmermans H A et al.. Percutaneous bioprosthetic venous valve: a long-term study in sheep.  J Vasc Surg. 2002;  35 598-602
  • 7 de Borst G J, Teijink J A, Patterson M, Quijano T C, Moll F. A percutaneous approach to deep venous valve insufficiency with a new self-expanding venous frame valve.  J Endovasc Ther. 2003;  10 341-349
  • 8 Pavcnik D, Machan L, Uchida B, Kaufman J, Keller F S, Rösch J. Percutaneous prosthetic venous valves: current state and possible applications.  Tech Vasc Interv Radiol. 2003;  6 137-142
  • 9 Badylak S F. Xenogeneic extracellular matrix as a scaffold for tissue reconstruction.  Transpl Immunol. 2004;  12 367-377
  • 10 Brountzos E, Pavcnik D, Timmermans H A et al.. Remodeling of the suspended small intestinal submucosa venous valve: an experimental study in sheep to asses the host cells' origin.  J Vasc Interv Radiol. 2003;  14 349-356
  • 11 Pavcnik D, Uchida B, Timmermans H A, Keller F S, Rösch J. Square stent: a new self-expandable endoluminal device and its applications.  Cardiovasc Intervent Radiol. 2001;  24 207-217
  • 12 Pavcnik D, Kaufman J, Uchida B et al.. Second-generation percutaneous bioprosthetic valve: a short-term study in sheep.  J Vasc Surg. 2004;  40 1223-1227
  • 13 Raju S. Venous insufficiency of the lower limb and stasis ulceration: changing concept and management.  Ann Surg. 1983;  197 688-697
  • 14 Zeitler E, Jecht E, Richter E I, Seyferth W. The treatment of male infertility by selective catheterization of the spermatic vein: technique, indications, complications, results.  ROFO Fortschr Geb Rontgenstr Nuklearmed. 1980;  132 294-300
  • 15 Machan L, Mowatt J, Hurwitz T, Doyle L, Fry P. Clinical outcome of women with chronic pelvic pain treated by ovarian vein embolization.  J Vasc Interv Radiol. 1998;  9(suppl) 185
  • 16 Venbrux A C, Chang A H, Kim H S et al.. Pelvic congestion syndrome (pelvic venous incompetence): impact of ovarian and internal iliac vein embolotherapy on menstrual cycle and chronic pelvic pain.  J Vasc Interv Radiol. 2002;  13 171-178
  • 17 Boudjemline Y, Bonhoeffer P. Percutaneous replacement of the pulmonary valve. In: Rao PS, Kern MJ Catheter Based Devices. Philadelphia; Lippincott Williams & Wilkins 2003: 511-514

D. PavcnikM.D. Ph.D. 

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