THE VALVULAR APPARATUS IN VENOUS INSUFFICIENCY - A PROBLEM OF QUANTITY

Abnormal venous valvular function may produce venous reflux and venous insufficiency. While valvular agenesis is a known, but rare cause of venous insufficiency. While valvular agenesis is a known, but rare cau se of venous insufficiency, little work has been done on the relative number of greater saphenous vein (GSV) valves in patients with venous insufficiency. This study investigates whether the GSV in patients wit h symptomatic venous insufficiency has fewer valves than the GSV of pa tients without venous insufficiency. The number of GSV valves in patie nts (n = 51) with symptomatic venous insufficiency undergoing saphenec tomy (VI) were compared with the number of GSV valves in patients (n = 26) without venous insufficiency undergoing in situ GSV bypass under angioscopic surveillance who served as a control group. The two groups differed, as expected, in age and sex distribution. The VI group had a mean of 25.7 +/- 11.0 centimeters of GSV between valves, while the c ontrol group had 19.0 +/- 9.7 centimeters of GSV between valves (F = 6 .99; p = 0.01). The mean number of valves in the saphenous veins of th e two groups also differed significantly: VI = 2.3 +/- 0.83 versus con trol (CTRL) = 4.8 +/- 2.01 (F = 61.86; p < 0.0001). That properly func tioning valve leaflets help maintain physiologic antegrade venous flow is indisputable. This study, however, suggests that the relative lack of valves may be related to the development of venous insufficiency. This report documents that patients with symptomatic reflux in the GSV have significantly fewer valves than patients with apparently normal functioning saphenous veins.