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Effect of external valvuloplasty of the deep vein in the treatment of chronic venous insufficiency of the lower extremity.
J Vasc Surg. 2006 Dec; 44(6):1296-300.JV

Abstract

OBJECTIVE

This study was conducted to verify the efficacy of external valvuloplasty of the femoral vein in the treatment of primary chronic venous insufficiency (PCVI).

METHODS

Forty patients with PCVI of the bilateral lower extremities were enrolled at the time of surgical management. All 80 limbs were classified as CEAP C2 to C4, with moderate incompetence of the deep vein. The limbs of each patient were randomized into one of two groups according to the operative method, so that when one limb was randomized to group A, regardless of whether it was the right or left limb, the other limb was assigned to group B. In group A, external valvuloplasty of the femoral vein was combined with surgery of the superficial venous system; in group B, surgery of the superficial venous system alone was performed. The therapeutic effects between the limbs in groups A and B were compared by color duplex scanning, a color Doppler velocity profile, air plethysmography (APG), and a CEAP severity score at 1 month, 1 year, and 3 years postoperatively.

RESULTS

Within each group of limbs, no significant differences were found in the average operative time within each group of limbs. The varicose veins resolved, there were no deep vein thromboses, and the wounds healed well postoperatively in all cases. Leg heaviness was relieved completely in 90% of group A limbs (36/40) and 55% of group B limbs (22/40). Venous valve competence was achieved in 100%, 98.1%, and 90.9% of group A limbs at 1 month, 1 year, and 3 years postoperatively, respectively. The amount of venous reflux, APG indices, and CEAP severity scores were not significantly different between the two groups preoperatively (P > .05). The amount of venous reflux, reflux indices, CEAP severity scores, and muscle pumping indices improved markedly in group A limbs postoperatively compared with group B limbs (P < .01); muscle pumping indices did not improve significantly in group B limbs postoperatively (P > .05). There were significant differences in the amount of venous reflux, reflux indices, and CEAP severity scores between group A and B limbs at 1 month and 1 year postoperatively (P < .01). There were significant differences in all parameters assessed between group A and B limbs 3 years postoperatively (P < .05).

CONCLUSIONS

External valvuloplasty of the femoral vein combined with surgical repair of the superficial venous system improved the hemodynamic status of the lower limbs, restored valvular function more effectively, and achieved better outcomes than surgical repair of the superficial venous system alone.

Authors+Show Affiliations

Department of Vascular Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Peoples Republic of China. ShenmingWang@sohu.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17145434

Citation

Wang, Shen-Ming, et al. "Effect of External Valvuloplasty of the Deep Vein in the Treatment of Chronic Venous Insufficiency of the Lower Extremity." Journal of Vascular Surgery, vol. 44, no. 6, 2006, pp. 1296-300.
Wang SM, Hu ZJ, Li SQ, et al. Effect of external valvuloplasty of the deep vein in the treatment of chronic venous insufficiency of the lower extremity. J Vasc Surg. 2006;44(6):1296-300.
Wang, S. M., Hu, Z. J., Li, S. Q., Huang, X. L., & Ye, C. S. (2006). Effect of external valvuloplasty of the deep vein in the treatment of chronic venous insufficiency of the lower extremity. Journal of Vascular Surgery, 44(6), 1296-300.
Wang SM, et al. Effect of External Valvuloplasty of the Deep Vein in the Treatment of Chronic Venous Insufficiency of the Lower Extremity. J Vasc Surg. 2006;44(6):1296-300. PubMed PMID: 17145434.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of external valvuloplasty of the deep vein in the treatment of chronic venous insufficiency of the lower extremity. AU - Wang,Shen-Ming, AU - Hu,Zuo-Jun, AU - Li,Song-Qi, AU - Huang,Xue-Ling, AU - Ye,Cai-Sheng, PY - 2006/04/20/received PY - 2006/07/26/accepted PY - 2006/12/6/pubmed PY - 2007/1/20/medline PY - 2006/12/6/entrez SP - 1296 EP - 300 JF - Journal of vascular surgery JO - J Vasc Surg VL - 44 IS - 6 N2 - OBJECTIVE: This study was conducted to verify the efficacy of external valvuloplasty of the femoral vein in the treatment of primary chronic venous insufficiency (PCVI). METHODS: Forty patients with PCVI of the bilateral lower extremities were enrolled at the time of surgical management. All 80 limbs were classified as CEAP C2 to C4, with moderate incompetence of the deep vein. The limbs of each patient were randomized into one of two groups according to the operative method, so that when one limb was randomized to group A, regardless of whether it was the right or left limb, the other limb was assigned to group B. In group A, external valvuloplasty of the femoral vein was combined with surgery of the superficial venous system; in group B, surgery of the superficial venous system alone was performed. The therapeutic effects between the limbs in groups A and B were compared by color duplex scanning, a color Doppler velocity profile, air plethysmography (APG), and a CEAP severity score at 1 month, 1 year, and 3 years postoperatively. RESULTS: Within each group of limbs, no significant differences were found in the average operative time within each group of limbs. The varicose veins resolved, there were no deep vein thromboses, and the wounds healed well postoperatively in all cases. Leg heaviness was relieved completely in 90% of group A limbs (36/40) and 55% of group B limbs (22/40). Venous valve competence was achieved in 100%, 98.1%, and 90.9% of group A limbs at 1 month, 1 year, and 3 years postoperatively, respectively. The amount of venous reflux, APG indices, and CEAP severity scores were not significantly different between the two groups preoperatively (P > .05). The amount of venous reflux, reflux indices, CEAP severity scores, and muscle pumping indices improved markedly in group A limbs postoperatively compared with group B limbs (P < .01); muscle pumping indices did not improve significantly in group B limbs postoperatively (P > .05). There were significant differences in the amount of venous reflux, reflux indices, and CEAP severity scores between group A and B limbs at 1 month and 1 year postoperatively (P < .01). There were significant differences in all parameters assessed between group A and B limbs 3 years postoperatively (P < .05). CONCLUSIONS: External valvuloplasty of the femoral vein combined with surgical repair of the superficial venous system improved the hemodynamic status of the lower limbs, restored valvular function more effectively, and achieved better outcomes than surgical repair of the superficial venous system alone. SN - 0741-5214 UR - https://www.unboundmedicine.com/medline/citation/17145434/Effect_of_external_valvuloplasty_of_the_deep_vein_in_the_treatment_of_chronic_venous_insufficiency_of_the_lower_extremity_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0741-5214(06)01370-X DB - PRIME DP - Unbound Medicine ER -