Deep Vein Valvular Incompetence: Options for Reconstruction

ABSTRACT

-Some degree of lower limb chronic venous insufficiency (CVI) affects over 30 million Americans. Varicosities have been recognized since 1500 b.c.; however, an accurate diagnosis of the variety of lower limb venous diseases and their treatment has made steady headway only in the recent past. Superficial and perforator insufficiency can be eliminated by a multitude of extirpative techniques. CVI due to advanced deep venous abnormalities is more problematic. Surgical intervention has become an option for end-stage patients who have failed conservative medical therapy. Direct in situ valve repairs are possible by a variety of methods. Secondary causes of valve damage can be corrected by transposition or transplant techniques. Many of these deep venous reconstructions can be supported by long-term data not available even 20 years ago. A quest for valve substitutes for patients with no native valves available for transplantation continues. Yet long-term follow-up with a precise gradation of improvement in signs, symptoms, and diagnostic studies is essential for continued growth in the field of deep venous reconstructions.

KEYWORD

Chronic venous insufficiency - venous surgery - deep venous disease