Does surgical correction of the superficial femoral vein valve change the course of varicose disease?

Abstract

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.

An anatomical study of femoral vein valves near the saphenofemoral junction

“…15 This is confirmed by satisfactory results of venous valve surgery of the common/femoral vein. 23,24 Hitherto, five imminent studies are known to the authors dealing with the existence and distribution of valves in the femoral veins.…”

“…12 Moreover, it has been reported that the prevalent progression of chronic venous insufficiency is associated with reflux in both the common/femoral vein and the great saphenous vein. 15 Contrary to the great saphenous vein, valves in the common femoral vein should exist more frequently in its proximal parts. 16 The frequency for a valve in the common femoral vein near the inguinal ligament has been stated from 67% up to 81% for Whites [17][18][19] and 93% for African specimens.…”

Deep venous external valvuloplasty using a rigid angioscope

“…Some patients are treated by a superfi cial venous operation alone, but McDaniel et al 5 reported that chronic venous ulcers tended to recur more in patients with deep venous insuffi ciency than in those without. Makarova et al 6 showed that the presence of deep venous insuffi ciency is a determining factor in the progress of the disease. Moreover, they stressed that superfi cial venous surgery alone did not improve progress, but deep venous surgery did.…”

Prevention and treatment of venous ulcers in primary chronic venous insufficiency

“…This normalization of venous flow is frequently seen with segmental primary deep incompetence, but rarely with axial deep reflux. [9][10][11][12] Mapping of reflux by duplex ultrasound scanning in limbs with primary or secondary reflux and leg ulceration has shown that superficial reflux is present in approximately 80% of limbs, and in half of these limbs it is combined with deep venous reflux. [13][14][15] The prevalence of significant NIVL in these patients is not known.…”