Five years' experience with vein valve transplant

Abstract

Since 1980, the vein valve transplant has been used to treat the venous insufficiency syndrome (VIS) in 66 patients (71 limbs). Seventy‐eight percent of patients who had close long‐term follow‐up reported improvement or complete relief of symptoms. On examination, 75% had decreased or resolved leg edema. In addition, 17 of 18 ulcers healed. The vein valve transplant is an effective long‐term treatment for VIS in patients who have failed initial medical management.

Reconstructive Surgery for Deep Vein Reflux in the Lower Limbs: Techniques, Results and Indications

“…These are given in Table 4. 37,39,40,43,44,[51][52][53]58,61,62 Successful outcome can be put at between 33% and 82% (follow-up period over 1 year) with valve competence between 16% and 87%, and haemodynamic performance little changed. It would appear that transplant to the popliteal vein yields better results.…”

A multicenter, phase I evaluation of cryopreserved venous valve allografts for the treatment of chronic deep venous insufficiency

“…23 Only six of 11 patients in the Atlanta series had competency confirmed by means of descending venography at 6 or more months after transplantation, and all valves were found to be competent. 24 Thirty-one of 71 valve transplants were venographically evaluated by Taheri et al, 6 with one occluded and two incompetent valves found, for a failure rate of 9.7%, but the length of follow-up is unclear. Raju's series evaluated 44 of 54 axillary vein valve transplants with serial duplex scanning follow-up, and he reported a 6-month valve competency rate of approximately 50%.…”

“…In an active venous practice, approximately 10% of postphlebitic patients with venous reflux actually have anatomy amenable to current surgical intervention. 5,6 This would suggest that approximately 200,000 people are potential candidates for aggressive surgical therapy, when warranted.…”

Venous reflux repair with cryopreserved vein valves

“…Autologous axillary vein transfers in a similar group of patients fared considerably better, with a lower occlusion rate (0%-18%) and higher competency rate (40% or better) than that of cryovalves at 2 years. 1,5,11,12 This study includes patients with known thrombophilia, infrainguinal outflow obstruction, and sometimes noncompliance with anticoagulation therapy. Since this graft will be used in patients with these types of disorders, the study group reflects clinical reality.…”