Results of valvuloplasty in patients presenting deep venous insufficiency and recurring ulceration

The purpose of this retrospective study was to assess mid-term results of v alvuloplasty in patients presenting chronic recurring venous stasis ulcerat ion. From 1988 to 1993, valvuloplasty was performed in the superficial femo ral vein of 33 lower extremities in 28 patients presenting recurring ulcera tion. In 23 cases, previous surgery in the superficial venous system or per forating vein had failed. Preoperative work-up demonstrated primary deep ve nous insufficiency (PDVI) in 22 extremities (group I), proximal PDVI in ass ociation with distal postthrombotic syndrome (PTS) in 10 (group II), and Kl ippel-Trenaunay syndrome in 1. Hemodynamic assessment with tourniquet place ment demonstrated a mean venous return time of 9 sec (+10, -8). Descending femoral phlebography showed Kistner grade 4 in 30 cases. Outcome was evalua ted by clinical examination and Dupplex scan with photophlethysmography at follow-up times ranging from 2 to 7.6 years (mean: 51 months). Correlation between outcome of valvuloplasty and clinical findings was excellent. The i ncidence of poor clinical and hemodynamic results was higher for patients w ith PTS. Valve repair in association with surgery for superficial vein insu fficiency and ligation of perforators gives good results in patients with i solated PDVI.