No abstract

Outcome of Valvuloplasty with Additional Procedures for Chronic Venous InsufficiencyInternal valvuloplasty for a deep vein with additional procedures (high ligation and stripping of saphenous vein etc.) were performed in 33 limbs of 31 patients with chronic venous insufficiency between February 1997 and February 2006. Air plethysmography was used to evaluate venous function since 2000. Recurrence of a leg ulcer was found in one case out of eight at the 15th postoperative month. The ulcer-recurrence-free survival rate was 100% at 1 year and 85.7% at 2 years postoperatively. One patient underwent reoperation 3 years after valvuloplasty because of bleeding from lipodermatosclerotic skin. All patients showed the improved symptoms as early results.Reflux of the femoral vein by descending venography improved from grade 3.3 to 1.4 after surgery. The venous filling index by air plethysmography was also improved from 7.5 ml/sec to 4.7 ml/sec. Identification of a target valve is an important technical aspect of valvuloplasty. Prevention of venous leaflet injury by meticulous attention was also important during venotomy. Deep vein thrombosis occurred in two cases postoperatively. (Conclusions) Internal valvuloplasty with additional procedures was an effective option for chronic venous insufficiency under strict indications. However, care must be taken to avoid postoperative deep vein thrombosis by antithrombotic therapy such as oral warfarin for one month after surgery.