EXTERNAL BANDING VALVULOPLASTY OF THE SUPERFICIAL FEMORAL VEIN IN THETREATMENT OF PRIMARY DEEP VALVULAR INCOMPETENCE

Primary deep venous insufficiency (PDVI) represents an important cause of chronic venous insufficiency (CVI). The clinical picture is genera lly related to a congenital weakness of the vein wall at the level of the valvular ring which may dilate its diameter with consequent length ening and prolapse of the valvular cusps. However, in an initial stage of PDVI the leaflets are normally formed and may undergo restorative surgery. In this condition an external banding valvuloplasty (EBV) wit h a Dacron sleeve around the incompetent valve may restore the compete nce. The authors report 54 cases of superficial femoral vein EBV perfo rmed over a period of 1986 to 1991. The patients were affected by sign s of CVI and/or relapsing, complicated or atypical varices in which de scending venography showed a grade II, III or IV primary deep reflux. In a mean follow-up of 38 months (4 to 63 months) deep reflux had disa ppeared in 41 patients (76%), had significantly decreased in 8 (14.8%) and was completely unmodified in 5 (9.2%). According to the experienc e of other authors, these results suggest the therapeutic validity of EBV in the initial stage of PDVI.