External banding valvuloplasty of the superficial femoral vein in the treatment of recurrent varicose veins

Objectives. The aim of this study is to evaluate the efficacy of reconstruc tive surgery of primary deep venous insufficiency in preventing recurrent v aricose veins. Design. Retrospective analysis of patients affected by recurrent varicose v eins submitted to external banding valvuloplasty of the superficial femoral vein. Setting. A division of vascular surgery in a hospital/scientific institute. Materials. Nineteen limbs (19 patients) with recurrent varicose veins, seve re chronic venous insufficiency and 3(rd) or 4(th) grade reflux in the supe rficial femoral vein and competence of the profunda femoris vein were selec ted for surgical reconstructive treatment after a complete diagnostic study by continuous wave Doppler duplex scanning and descending phlebography. Interventions. External banding valvuloplasty of the superficial femoral ve in was performed in all cases: A Dacron sleeve was used in nine patients an d Venocuff in 10. Results. In one case a deep venous thrombosis of the calf occurred in the f irst postoperative period; in three cases the correction of the deep reflux was incomplete and a recurrence of the varices was observed. After a mean follow-up of 50 months, abolition of reflux and relief of symptomatology we re obtained in 15 cases (78%). Conclusions. Primary deep venous insufficiency, unknown at the time of the initial operation, may be the cause of recurrent Varicose veins. External b anding valvuloplasty of the superficial femoral Vein may abolish the reflux and correct venous hypertension, preventing recurrences.