H. Schanzer et al., THE ROLE OF EXTERNAL BANDING VALVULOPLASTY IN THE SURGICAL-MANAGEMENTOF CHRONIC DEEP VENOUS DISEASE, Phlebology, 9(1), 1994, pp. 8-12
Objective: Correction of venous reflux by perivalvular banding in pati
ents suffering from chronic venous stasis secondary to primary valvula
r incompetence. Design: Prospective study in a group of patients with
severe venous insufficiency. One patient (one extremity) was lost to f
ollow-up. Setting: Tertiary care teaching hospital. Patients: Twelve p
atients (13 extremities) with severe or moderate venous insufficiency.
Interventions: Correction of valvular incompetence by narrowing a val
vular ring with an external band. Twenty-seven bands were fitted to in
competent valves of 13 extremities. Main outcome measures: Abolition o
f reflux and improvement of muscle pump measured by clinical, plethysm
ographic and venographic criteria. Results: Symptomatic improvement wa
s found in 10 extremities (77%) and complete correction of reflux on v
enography in eight extremities (67%). Plethysmographically measured re
flux improved in 6 extremities (50%) and muscle pump function improved
in 7 extremities (58%). No correlation was found between plethysmogra
phic and clinical or venographic outcome. Conclusion: Perivalvular ban
ding can correct reflux and alleviate clinical symptoms of chronic ven
ous stasis in patients with primary valvular incompetence. Selection o
f patients, valves to be corrected, necessary degree of valvular ring
narrowing and need for additional interventions should be further inve
stigated.