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THE JOURNAL OF CARDIOVASCULAR SURGERY
A Journal on Cardiac, Vascular and Thoracic Surgery
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632
ORIGINAL ARTICLES VASCULAR SECTION
The Journal of Cardiovascular Surgery 2007 February;48(1):21-5
Intermediate-term results of angioscopy-assisted anterior valve sinus plication for primary deep venous insufficiency
Nishibe T. 1,2, Kudo F. 2, Miyazaki K. 2, Kondo Y. 1, Koizumi J. 3, Dardik 4, Nishibe M. 5
1 Division of Cardiovascular Surgery Department of Cardiovascular Surgery Fujita Health University, Toyoake, Japan
2 Department of Cardiovascular Surgery Hokkaido University School of Medicine, Sapporo, Japan
3 Department of Radiology, Tokai University School of Medicine Isehava, Japan
4 Department of Vascular Surgery Yale University School of Medicine, New Haven, CT, USA
5 Department of Surgery Eniwa Midorino Clinic, Eniwa, Japan
Aim. The intermediate-term efficacy of angioscopy-assisted anterior valve sinus plication for primary deep venous insufficiency was evaluated.
Methods. Twelve limbs in 11 patients had class 4 or higher disease on the SVS/ISCVS classification. Descending venography revealed grade-3 or 4-reflux in all limbs. The limbs were treated with angioscopy-assisted anterior valve sinus plication of the highest valve of the superficial femoral vein. Clinical evaluation and air plethysmography were performed at the final follow-up.
Results. The mean follow-up was 38.4 months with a range of 24 to 48 months. Postoperative descending venography revealed significant improvement of the reflux of the superficial femoral vein. At the final follow-up, all patients reported relief of subjective symptoms. The ulcers healed and did not recur in the single limb with class-6 disease, the ulcers did not recur in four class-5 limbs, and there was a distinct clinical improvement with resolution of skin changes in the seven class-4 limbs. The venous filling index measured by air plethysmography was in a normal range in 8 of the 12 limbs.
Conclusions. Angioscopy-assisted anterior valve sinus plication may be a surgical technique that results in intermediate-term clinical and hemodynamic improvement in patients with primary deep venous insufficiency.