Effect of external valvuloplasty of the deep vein in the treatment of chronic venous insufficiency of the lower extremity

Wang, Shenming; Hu, Zhiqiang; Li, Songqi; Huang, Xinsheng; Ye, Caisheng

doi:10.1016/j.jvs.2006.07.043

Cited by 35 publications

(18 citation statements)

References 18 publications

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“…Overall, this technique appears applicable and effective in select patients, with expectations of a 50% ulcer-free rate at 2 years. [377][378][379][380][383][384][385][386][387][388][389][390] Internal valvuloplasty is an anatomically precise technique that has been modified over time. Although internal valvuloplasty provides the longest durability, it is technically more demanding and highly operator dependent.…”

Section: Level Of Evidence -C]mentioning

confidence: 99%

Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum

O’Donnell¹,

Passman²,

Marston³

et al. 2014

Journal of Vascular Surgery

576

450

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Section: Level Of Evidence -C]mentioning

confidence: 99%

Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum

O’Donnell¹,

Passman²,

Marston³

et al. 2014

Journal of Vascular Surgery

576

450

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“…The direct relationship between clinical improvement and competency of the reconstruction and its durability is also shown. 12,20,[23][24][25][26][27][28][29][30] Technical aspects and outcomes While some favor the internal valve plasty as more durable, it has the following disadvantages: it requires a venotomy with the risk of cusp damage and assessment cannot be done until the venotomy is closed. External trans-commissural valve plasty may be as effective as the internal technique but it requires adventitial dissection.…”

Section: Results and Outcomesmentioning

confidence: 99%

Valve reconstructions

Rosales

2015

Phlebology

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The history of venous valve reconstruction extends back to 1968 when Robert L Kistner performed the first internal valve plasty to treat deep venous axial reflux. Throughout the past 50 years other techniques of reconstructive deep venous surgery (RDVS) were developed, not only to repair but also to replace venous valves. And the fact that several surgeons and centers have undertaken RDVS in the treatment of chronic venous insufficiency (CVI) reporting outcomes, has added knowledge to define more clearly the role of this kind of specialized surgery. Patients who may benefit from RDVS are among those where conventional treatment with compression stockings combined with superficial surgery has failed. Ulcer-healing rates of up to 70% have been reported after RDVS and ulcer-free periods of up to 36 months have been generated. But during five-year follow-up, freedom from ulceration period and clinical improvement rates were reduced significantly. This raises then the issue and challenge of durability of RDVS since the average age of patients who can benefit from it is about 50 years.

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“…In the advanced stage of the disease, which is associated with compromised skin integrity, pneumatic compression [Berliner et al, 2003] and sclerofoam therapy have proven to be beneficial [Bergan and Pascarella, 2005]. Besides these conservative therapy options, a small variety of surgical treatment options aiming at the restoration of venous valve function have also been developed and introduced, such as valve repair or valve transplantation [Wang et al, 2006;Rathbun and Kirkpatrick, 2007;Nael and Rathbun, 2009]. None of these methods have so far been generally accepted in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Tissue Engineering of Vein Valves Based on Decellularized Natural Matrices

Mogaldea

Goecke²,

Theodoridis³

et al. 2017

Cells Tissues Organs

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Valvular repair or transplantation, designed to restore the venous valve function of the legs, has been proposed as treatment in chronic venous insufficiency. Available grafts or surgeries have provided limited durability so far. Generating venous valve substitutes by means of tissue engineering could be a solution. We generated decellularized jugular ovine vein conduits containing valves (oVVC) after reseeding with ovine endothelial cells differentiated from peripheral blood-derived endothelial cells (oPBEC), cultivated in vitro corresponding to the circulatory situation in the lower leg at rest and under exertion. oVVC were decellularized by detergent treatment. GFP-labeled oPBEC were seeded onto the luminal side of the decellularized oVVC and cultivated under static-rotational conditions for 6 h (group I) and 12 h (group II), respectively. Reseeded matrices of group I were exposed to continuous low flow conditions (“leg at rest”). The tissues of group II were exposed to a gradually increasing flow (“leg under effort”). After 5 days, the grafts of group I revealed a uniform luminal endothelial cell coverage of the examined areas of the venous walls and adjacent venous valve leaflets. In group II, the cell coverage on luminal areas of the venous wall parts was found to be nearly complete. The endothelial cell coverage of adjacent venous valve leaflets was revealed to be less dense and confluent. Endothelial cells cultured on acellular vein tissues of both groups were distinctly orientated uniformly in the flow direction, clearly creating a stable and flow-orientated layer. Thus, an endothelium could successfully be reestablished on the luminal surface of a decellularized venous valve by seeding peripheral blood endothelial cells and culturing under different conditions.

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Effect of external valvuloplasty of the deep vein in the treatment of chronic venous insufficiency of the lower extremity

Cited by 35 publications

References 18 publications

Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum

Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum

Valve reconstructions

Tissue Engineering of Vein Valves Based on Decellularized Natural Matrices

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