Expanded polytetrafluoroethylene in external valvuloplasty for superficialor deep vein incompetence

The authors evaluated the long-term safety of expanded polytetrafluoroethyl ene (ePTFE) implants used in external valvuloplasty for treatment of incomp etence of the long saphenous and common and superficial femoral veins. Duri ng a 15-year period patients with superficial and/or deep venous disease an d hypertension due to pure superficial or deep vein incompetence underwent an external valvuloplasty with ePTFE sutures, or an ePTFE cardiovascular pa tch placed as a sleeve around the incompetent vein segment, or an ePTFE tub ular graft placed around the venous segment. Postoperative follow-up evalua tions consisted of clinical examinations, high-resolution ultrasonography, and color duplex scanning, and a complete blood count performed at 1, 3 and 6 months, and repeated for at least 4 years, every 2 years after the proce dure. A total of 101 patients (38 men and 63 women; mean [+/- sd] age, 44 /- 12 years) underwent external valvuloplasty between January 1983 and Dece mber 1998; 82 of them completed the 4-year follow-up. Forty of the 82 patie nts had been operated on for superficial vein incompetence, 42 for deep vei n incompetence. Overall, the mean followup time was 7.8 +/- 3.6 years (rang e, 4 to 13). There were no infections, thromboses, foreign-body reactions t o the ePTFE implants, or other prosthesis-related complications requiring e xplantation. One granuloma (noninfected) developed in association with a tu bular ePTFE implant around a long saphenous vein, but it did not necessitat e implant removal. Seven patients required (at least after 4 years) a secon d procedure for recurrent or new venous incompetence. Therefore, in this ob servational study, ePTFE implants used to treat or correct venous incompete nce were well tolerated on a longterm basis.