Vein valve transplantation

Use of Ipsilateral Greater Saphenous Vein as a Valved Transplant in Management of Post-Thrombotic Deep Venous Insufficiency: Long-Term Results

“…Much lower success rates, on the order of 25%, have been observed when deep vein surgery was performed without prior or concomitant treatment of superficial insufficiency. 13,16 This finding argues for treatment of superficial vein insufficiency either before or during deep vein surgery. Our own policy in patients with associated deep and superficial venous insufficiency is to correct incompetent superficial veins first and treat deep veins only if this fails.…”

“…Because of diameter mismatch, transplantation of valved vein segments such as the contralateral GSV has not been widely used even though this problem could be resolved by combining end-toside anastomosis and ligation of the SFV as described in this study. The most widely used technique is transposition of the axillary vein onto the SFV as advocated by Taheri et al 13 However, longterm results have been disappointing; duplex scanning has demonstrated that only 30% of grafts were competent at 2 years. 11 Two transposition techniques are available: transposition of the SFV to the incompetent deep femoral vein or transposition of the GSV to the SFV.…”

Endovenous Valve Transfer for Chronic Deep Venous Insufficiency

“…The greatest challenge for the post-phlebitic limb is to provide a minimally invasive procedure of widespread applicability and to avoid long-term deterioration following free valve transfer. Specifically, Taheri et al 25 note a progressive dilatation of the valve ring with deterioration of valve function following brachial valve transfer to the femoral vein. Bry et al 11 transferred axillary valves to the popliteal for better size matching as it was thought that the popliteal vein was the gatekeeper to the calf.…”

Consensus Paper on Venous Leg Ulcer

“…Vein valve transplants, 153,154 valvuloplasties, 155,156 and venous transposition operations 157 for deep venous insufficiency are still under development. These procedures should only be undertaken in specialized centers in properly designed prospective clinical studies 158 .…”