A New Technique for Creation of Femoral Vein Monocusp Neovalve for Patients With Primary Deep Vein Incompetence

Abstract

Chronic venous insufficiency due to deep vein incompetence (DVI) is difficult to treat and is prone for failure and recurrence of venous ulcers. A variety of techniques have been tried to create valve competency but majority of them have been difficult to perform and have not shown long term results. Opie reported a technique for construction of a monocusp neo valve. We have modified this procedure and successfully corrected the deep vein reflux in a patient with primary DVI.

Methods

Monocusp valve was created by folding the vein wall flap so that both sides of the valve will have intimal surface.

Result

Patient had excellent symptomatic improvement. The venous ulcer healed with skin grafting and had not recurred at 30 months follow up. Descending venogram and duplex scan showed mild reflux.

Conclusion

Monocusp neo valve creation for primary DVI is a simple procedure with good long-term result.

Keywords

chronic venous insufficiency deep vein reflux venous insufficiency surgery venous reflux interventions

Get full access to this article

View all access options for this article.

References

Maleti

Perrin

. Reconstructive surgery for deep vein reflux in the lower limbs: techniques, results and indications. Eur J Vasc Endovasc Surg. 2011;41:837-848.

Kistner

. Surgical repair of a venous valve. Straub Clin Proc. 1968;24:41-43.

Kistner

. Surgical repair of the incompetent femoral vein valve. Arch Surg. 1975;110:1336-1342.

Raju

Fredericks

. Valve reconstruction procedures for nonobstructive venous insufficiency: rationale, techniques, and results in 107 procedures with two- to eight-year follow-up. J Vasc Surg. 1988;7:301-310.

Perrin

. Reconstructive surgery for deep venous reflux: a report on 144 cases. Cardiovasc Surg. 2000;8:246-255.

Plagnol

Ciostek

Grimaud

Prokopowicz

. Technique de reconstruction valvulaire autoge`ne dans le syndrome de reflux postphle´bitique. Ann Chir Vasc. 1999;13:339-342.

Raju

Hardy

. Technical options in venous valve reconstruction. Am J Surg. 1997;173:301-307.

Neglen

Raju

. Venous reflux repair with cryopreserved vein valves. J Vasc Surg. 2003;37:552-557.

Ulloa

Glickman

. Human trial using the novel bioprosthetic VenoValve in patients with chronic venous insufficiency. J Vasc Surg Venous Lymphat Disord. 2021;9:938-944.

10.

Maleti

Lugli

. Neovalve construction in post-thrombotic syndrome. J Vasc Surg. 2006;43:794-799.

11.

Opie

JC1

Izdebski

Payne

Opie

. Monocusp - novel common femoral vein monocusp surgery uncorrectable chronic venous insufficiency with aplastic/dysplastic valves. Phlebology. 2008;23(4):158-171.

12.

Ignatyev

Akhmetzyanov

. 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.