In patients with chronic venous insufficiency, two types of clinical dynamics, stable and progressive, can be identified. The progressive type is associated with the presence of superficial femoral vein reflux and increasing greater saphenous vein reflux. Superficial vein surgery neither corrects superficial femoral vein reflux nor prevents it from progressing further. Correction of a single superficial femoral vein valve during primary intervention significantly improves the long-term results of superficial venous surgery. This improvement is associated with the prevention of reflux progression. Surgical correction of the incompetent superficial femoral vein valve changes the course of primary chronic venous insufficiency.

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UF our hundred thirty-six patients with acute unilateral thrombosis in the iliofemoral venous segment were followed up to establish the relationship between changes in the veins and clinical dynamics of postthrombotic syndrome. Physical examination and ascending phlebography were performed at the time of admission and 1 month later. Follow-up visits (physical examination and venous ultrasound study) were performed annually during 10 years. Cumulative rate of class 0 extremities decreased from 89% at the first year to 59% after 10 years. Progressive dynamics was seen in 41% of cases; 17% of these extremities had occlusions, and 83% had proximal reflux; 59% of the extremities demonstrated stable-type clinical dynamics. Occlusions were found in 41% and reflux in 59% of these cases. Recanalization and valvular incompetence at the site of the initial deep vein thrombosis are more likely to lead to progressive type of the disease. Valvular incompetence in the distal veins does not correlate with severity of the disease.From the *Sverdlovsk Vascular Center, Ekaterinburg, and the tUrals Medical Academy, Ekaterinburg, Russia.