Reparative surgery of valves in the treatment of superficial venous insufficiency. External banding valvuloplasty versus high ligation or disconnection. A prospective multicentric trial

L. Corcos, D. De Anna, P. Zamboni, V. Gasbarro, V. Bresadola, T. Procacci, A. Liboni, C. Macchi, I. Donini

Research output: Contribution to journalArticlepeer-review

Abstract

Objective. A prospective study was performed in order to compare results obtained in the treatment of early and/or limited primary varicose veins of the lower limbs using two different procedures: external valvuloplasty and high ligation or disconnection of the sapheno-femoral junction. Materials and Methods. 116 limbs (113 patients) were selected. 57 with normal cusps in dilated valves were subjected to external valvuloplasty with Silicone prosthesis under Doppler control (intraoperative angioscopy in 16 cases); 59 limbs were subjected to high ligation or disconnection of the junction; 57 limbs out of 116 were subjected to complementary procedures. Duplex and photoplethysmographic examinations were performed before and after the surgical procedures in all patients. Doppler venous pressures were measured in 36 limbs and invasive pressures in 40 limbs. Patients were postoperatively followed up every 4 months until the 12th month. Results. Indications for valvuloplasty were found in 8,2% of cases and in 66,3% of the early varices. Clinical results were slightly superior in the reparative surgery group. Thrombotic occlusion of the proximal long saphenous vein was significantly higher in the ligation-disconnection group. Results from photoplethysmography and venous pressure measurements indicated that both operations are equally effective in the elimination of reflux in the junction. Normal flow was restored in the long saphenous vein by valvuloplasty, while a reverse flow was observed in all the patent veins after ligation or disconnection. Conclusions. Salvaging the sapheno-femoral junction is more physiological and advisable than anatomical elimination. External valvuloplasty can be a prefereable alternative to ligation or disconnection in selected patients.

Original languageEnglish
Pages (from-to)128-136
Number of pages9
JournalJournal des Maladies Vasculaires
Volume22
Issue number2
Publication statusPublished - May 1997

Keywords

  • varicose veins
  • venous banding
  • venous insufficiency
  • venous valves

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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