Autogenous valve reconstruction technique for post-thrombotic reflux.

Abstract

Post-thrombotic reflux in deep veins of the lower extremities cannot be treated by in situ valvuloplasty because of valve degeneration. The outcome of transplantation and transposition of segments with valves is controversial. From feasibility tests in animals and fresh human cadavers we have developed an autogenous valve reconstruction technique. The valve is fashioned from the proximal end of the greater saphenous vein that is left attached to the femoral vein, invaginated, and fixed to the venous wall. This technique provides a competent bicuspid valve. In a series of 19 patients operated on in 1995 we performed 20 valve reconstruction procedures at the level of the femorosaphenous junction by invagination of a fragment from the proximal end of the greater saphenous vein in the common femoral vein. Mean follow-up time was 10 months. No complications were observed. All femoral veins were patent and competent except one in which mild reflux was observed because of insufficient valve size. Further follow-up is needed to confirm the efficacy of this simple, new technique.