Venous hemodynamic changes after external banding valvuloplasty with varicosectomy in the treatment of primary varicose veins

Background. To evaluate venous hemodynamic changes after an external bandin g valvuloplasty in the treatment of primary varicose veins with saphenofemo ral incompetence. Methods. From June 1996 to December 1997, 79 limbs (10 male and 69 female, age 20-57 years) were treated for primary saphenofemoral incompetence by ex ternal banding valvuloplasty, Tightening of the banding was accomplished us ing a polyester-tailored mesh to narrow the terminal and/or subterminal val ve areas of the dilated greater saphenous vein (GSV), same size as its mini mum diameter during spasm. Evaluation was done through a pre- and postopera tive color-flow duplex scanning and an air-plethysmography (APG). Results. Sixty-three limbs (79.7%) remained patent and were competent. Four teen Limbs (17.7%) remained patent but showed reflux. Two Limbs (2.5%) had thrombus within the GSV after surgery. The diameter of GSV of mid-thigh was 6.7+/-1.6 mm preoperatively and 4.1+/-0.9 mm postoperatively (p-value=7.04 E-10). Reduction of the diameter was 61.4+/-12.3%. Venous volume was 136.1/-59.8 ml preoperatively and 103.5+/-39.8 mi postoperatively (p-value=1.6E- 20). Reduction of the venous volume was 12.9+/-17.0%, Venous filling index (VFI) was 6.6+11.3 ml/sec preoperatively and 1.9+/-3.3 ml/sec postoperative ly (p-value=1.2E-10). Reduction of the VFI was 55.0+/-29.1%. Ejection fract ion (EF) was 48.9+/-13.8% preoperatively and 60.1+/-17.2% postoperatively ( p-value=2.6E-17). Increase of EF was 29.4+/-43.5%. The residual volume frac tion (RVF) was 42.1+/-13.9% preoperatively and 30.2+/-14.5% postoperatively (p-value=5.6E-19). Reduction of RVF was 17.6+/-43.6%. Conclusions. Early evaluation of saphenofemoral external banding valvulopla sty confirms the satisfactory patency and improvement in venous hemodynamic s. Longterm evaluation is clearly indicated but the early safety and effica cy of the procedure have been confirmed.