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Long-term results of the monocusp valve formation in the common femoral vein in patients with avalvular deep veins of the lower extremities.
Int Angiol. 2017 Apr; 36(2):116-121.IA

Abstract

BACKGROUND

Aim of the study was to evaluate the long-term results of the monocusp valve formation in the common femoral vein (CFV) in patients with avalvular deep veins (ADV) of the lower extremities.

METHODS

A total of 36 patients (24 women and 12 men) at the age varying from 37 to 58 years old were given surgical treatment during the period from 2008 to 2014. Six patients presented with congenital ADV, while the remaining 30 ADV had a consequence of the post-thrombotic lesion in the valves with the complete recanalization and manifested deep venous axial reflux. In terms of CEAP clinical classification, the patients were categorized into the following groups: С4b (N.=11), C5 (N.=18), C6 (N.=7). All the patients underwent Duplex ultrasound (DUS) examination. Twelve patients were additionally examined by venography. Kistner grade IV reflux was diagnosed in all the patients. Twenty-eight patients had undergone surgical interventions on superficial and perforating veins before. The severe (C4b-C6) forms of chronic venous disease with manifested axial reflux in deep veins were regarded as an indication for surgery in the patients refractory to traditional treatment. The method described by Opie et al. was employed to construct the monocusp venous valve in the CFV.

RESULTS

The long-term results of the treatment were evaluated in 26 patients followed up during the period from 18 to 48 (mean 29.5±8.2) months. Cumulative clinical success rate at four years was 76.5%. Freedom from ulcer recurrence at four years was 83.4% (C6 patients). Cumulative competence rate of the neovalve was accomplished in 70.6%. The evaluation in two years based on the VCSS revealed the reduction in the severity of the manifestations of chronic venous insufficiency (P<0.01). The quality of life was improved, its index decreased from 60.6±18.7 to 40.7±12.8 (P<0.05). The circumference of the narrowest segment of the tibia decreased from 271.1±4.7 to 256.8±5.7 mm (P<0.05).

CONCLUSIONS

Formation of the monocusp valve in CFV makes it possible to eliminate pathological blood reflux from the inferior vena cava to deep veins of the lower extremities that is known to be one of the main factors in the appearance and progression of chronic venous insufficiency (CVI). The high effectiveness of this operation is confirmed by the well apparent clinical improvement in the state of the affected lower extremity and the quality of life of the patients.

Authors+Show Affiliations

Department of Vascular Surgery, Interregional Clinical and Diagnostic Center, Course of Cardiovascular Surgery, Russian State Medical University, Kazan, Russia - imignatiev@rambler.ru.Department of Vascular Surgery, Interregional Clinical and Diagnostic Center, Course of Cardiovascular Surgery, Russian State Medical University, Kazan, Russia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27362576

Citation

Ignatyev, Igor M., and Rustem V. Akhmetzyanov. "Long-term Results of the Monocusp Valve Formation in the Common Femoral Vein in Patients With Avalvular Deep Veins of the Lower Extremities." International Angiology : a Journal of the International Union of Angiology, vol. 36, no. 2, 2017, pp. 116-121.
Ignatyev IM, Akhmetzyanov RV. Long-term results of the monocusp valve formation in the common femoral vein in patients with avalvular deep veins of the lower extremities. Int Angiol. 2017;36(2):116-121.
Ignatyev, I. M., & Akhmetzyanov, R. V. (2017). Long-term results of the monocusp valve formation in the common femoral vein in patients with avalvular deep veins of the lower extremities. International Angiology : a Journal of the International Union of Angiology, 36(2), 116-121. https://doi.org/10.23736/S0392-9590.16.03638-5
Ignatyev IM, Akhmetzyanov RV. Long-term Results of the Monocusp Valve Formation in the Common Femoral Vein in Patients With Avalvular Deep Veins of the Lower Extremities. Int Angiol. 2017;36(2):116-121. PubMed PMID: 27362576.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term results of the monocusp valve formation in the common femoral vein in patients with avalvular deep veins of the lower extremities. AU - Ignatyev,Igor M, AU - Akhmetzyanov,Rustem V, Y1 - 2016/06/30/ PY - 2016/7/1/pubmed PY - 2017/9/16/medline PY - 2016/7/1/entrez SP - 116 EP - 121 JF - International angiology : a journal of the International Union of Angiology JO - Int Angiol VL - 36 IS - 2 N2 - BACKGROUND: Aim of the study was to evaluate the long-term results of the monocusp valve formation in the common femoral vein (CFV) in patients with avalvular deep veins (ADV) of the lower extremities. METHODS: A total of 36 patients (24 women and 12 men) at the age varying from 37 to 58 years old were given surgical treatment during the period from 2008 to 2014. Six patients presented with congenital ADV, while the remaining 30 ADV had a consequence of the post-thrombotic lesion in the valves with the complete recanalization and manifested deep venous axial reflux. In terms of CEAP clinical classification, the patients were categorized into the following groups: С4b (N.=11), C5 (N.=18), C6 (N.=7). All the patients underwent Duplex ultrasound (DUS) examination. Twelve patients were additionally examined by venography. Kistner grade IV reflux was diagnosed in all the patients. Twenty-eight patients had undergone surgical interventions on superficial and perforating veins before. The severe (C4b-C6) forms of chronic venous disease with manifested axial reflux in deep veins were regarded as an indication for surgery in the patients refractory to traditional treatment. The method described by Opie et al. was employed to construct the monocusp venous valve in the CFV. RESULTS: The long-term results of the treatment were evaluated in 26 patients followed up during the period from 18 to 48 (mean 29.5±8.2) months. Cumulative clinical success rate at four years was 76.5%. Freedom from ulcer recurrence at four years was 83.4% (C6 patients). Cumulative competence rate of the neovalve was accomplished in 70.6%. The evaluation in two years based on the VCSS revealed the reduction in the severity of the manifestations of chronic venous insufficiency (P<0.01). The quality of life was improved, its index decreased from 60.6±18.7 to 40.7±12.8 (P<0.05). The circumference of the narrowest segment of the tibia decreased from 271.1±4.7 to 256.8±5.7 mm (P<0.05). CONCLUSIONS: Formation of the monocusp valve in CFV makes it possible to eliminate pathological blood reflux from the inferior vena cava to deep veins of the lower extremities that is known to be one of the main factors in the appearance and progression of chronic venous insufficiency (CVI). The high effectiveness of this operation is confirmed by the well apparent clinical improvement in the state of the affected lower extremity and the quality of life of the patients. SN - 1827-1839 UR - https://www.unboundmedicine.com/medline/citation/27362576/Long_term_results_of_the_monocusp_valve_formation_in_the_common_femoral_vein_in_patients_with_avalvular_deep_veins_of_the_lower_extremities_ L2 - https://www.minervamedica.it/index2.t?show=R34Y2017N02A0116 DB - PRIME DP - Unbound Medicine ER -