Reconstructive surgery for deep venous reflux: a report on 144 cases

This retrospective study was conducted on 144 lower extremities (133 patien ts) with deep venous reflux treated with surgery to restore venous valvular function. Clinically, 51% of patients were in class CS-CG, and based on et iology, patients were equally divided into primary and secondary venous dis ease. Four surgical procedures were used: valvuloplasty (n = 85), transposi tion (n = 18), transplantation (n = 32), or Psathakis' technique II (n = 9) , The procedure chosen was determined mainly by the feasibility of the tech nique in the above mentioned preferred order, Thus, 76% of valvuloplasties were performed for primary venous insufficiency, A postoperative venography routinely performed soon after surgery demonstrated a large number of segm ental thromboses (20.3%), Their number was statistically different in prima ry and secondary (PTS) venous disease, respectively 8.8 vs 32.3%, Clinical and hemodynamic results were evaluated (duration of follow-up: 12-168 month s) based on etiology and type of procedure. A correlation was established b etween clinical result (venous ulcer) and efficacy of valvular reconstructi on. The latter was satisfactory in valvuloplasties (P = 0.005) but not in v enous transfer (P = 0.35), Overall results were better for primary venous i nsufficiency than in postthrombotic syndromes (P = 0.03), (C) 2000 The Inte rnational Society for Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights reserved.