Reconstructive Surgery for Deep Venous Reflux: A Report on 144 Cases

This retrospective study was conducted on 144 lower extremities (133 patients) with deep venous reflux treated with surgery to restore venous valvular function. Clinically, 51% of patients were in class C5–C6, and based on etiology, patients were equally divided into primary and secondary venous disease. Four surgical procedures were used: valvuloplasty ( n = 85), transposition ( n = 18), transplantation ( n = 32), or Psathakis' technique II ( n = 9). The procedure chosen was determined mainly by the feasibility of the technique in the above-mentioned preferred order. Thus, 76% of valvuloplasties were performed for primary venous insufficiency. A postoperative venography routinely performed soon after surgery demonstrated a large number of segmental thromboses (20.3%). Their number was statistically different in primary and secondary (PTS) venous disease, respectively 8.8 vs 32.3%. Clinical and hemodynamic results were evaluated (duration of follow-up: 12–168 months) based on etiology and type of procedure. A correlation was established between clinical result (venous ulcer) and efficacy of valvular reconstruction. The latter was satisfactory in valvuloplasties ( P = 0.005) but no