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Abstract

Some degree of lower limb chronic venous insufficiency (CVI) affects over 30 million Americans. Varicosities have been recognized since 1500 B.C.; however, an accurate diagnosis of the variety of lower limb venous diseases and their treatment has made steady headway only in the recent past. Superficial and perforator insufficiency can be eliminated by a multitude of extirpative techniques. CVI due to advanced deep venous abnormalities is more problematic. Surgical intervention has become an option for end-stage patients who have failed conservative medical therapy Direct in situ valve repairs are possible by a variety of methods. Secondary causes of valve damage can be corrected by transposition or transplant techniques. Many of these deep venous reconstructions can be supported by long-term data not available even 20 years ago. A quest for valve substitutes for patients with no native valves available for transplantation continues. Yet long-term follow-up with a precise gradation of improvement in signs, symptoms, and diagnostic studies is essential for continued growth in the field of deep venous reconstructions.

Keywords

Chronic venous insufficiency venous surgery deep venous disease

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Deep Vein Valvular Incompetence: Options for Reconstruction

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