Has external banding become a historical technique during venous valve repair?

Abstract

OBJECTIVE:In deep venous valve repair, transcommissural external valvuloplasty (TEV) is the commonly used technique. In some cases, external banding (EB) is combined with this procedure to improve the patency and durability of the surgical procedure. METHODS:We retrospectively analyzed patients who underwent deep venous valve repair from 1998 through 2018. Patients were divided according to the surgical procedure: Group A: TEV alone and Group B: TEV+EB. Early postoperative outcomes of the procedure were compared between the groups.RESULTS: There were 265 patients in Group A and 165 patients in Group B. The mean follow-up period was 4.2±3.7. The rate of recurrence of venous reflux, ulcer, and reoperation were 31.9 versus 30.9, 21.2 versus 21.8, and 16.7 versus 13.9 in Group A and Group B, respectively. There were 67 reoperations in the follow-up period. At reoperation, external valvuloplasty was performed in 64% of the reoperations in Group A, while this rate was 13% for Group B.CONCLUSIONS: There is no more need for EB during the venous valve repair with the increased experience of valvuloplasty techniques.TEV might be enough with acceptable long-term outcomes during deep venous reconstruction.

Surgical outcomes of split-thickness skin grafts versus free flaps of the lateral thoracic region for incurable chronic venous ulcers

“…Healthy tissue harvested for the free-flap procedure contains many normal valves, which can store and drain venous blood by replacing abnormal tissue [10]. While sclerotherapy [12], valvuloplasty [13], and embolization/ligation of veins, perforator vessels, and feeding vessels [14] are being attempted as surgical treatment for venous insufficiency, these are procedures performed on localized veins and are methods that simply "repair" the abnormal vein system. On the other hand, free-flap surgery that can "replace" many healthy venous systems can theoretically be a fundamental treatment modality for venous ulcers.…”