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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES VASCULAR SECTION
The Journal of Cardiovascular Surgery 2001 August;42(4):529-35
Femoral vein valve repair with angioscopy-assisted anterior valve sinus plication. Early results
Nishibe T., Kudo F., Flores J., Miyazaki K., Yasuda K.
From the Department of Cardiovascular Surgery Hokkaido University School of Medicine Sapporo, Japan
Background. The efficiency of angioscopy-assisted anterior valve sinus plication for primary deep venous insufficiency was evaluated.
Methods. Experimental design: retrospective, clinical study with short follow-up. Setting: institutional practice. Patients: 15 limbs in 12 patients had class 4 or higher disease (SVS/ISCVS classification). Descending venography showed class 3 or 4 reflux in all patients. Venous refilling time (VRT) was abnormal (<15 sec) in all of the nine limbs in which photoplethysmography was conducted. The limbs were treated with angioscopy-assisted anterior valve sinus plication of the superficial femoral vein. Postoperative descending venography was performed between the first and third day after operation. Clinical evaluation and VRT measurement were repeated when the patients were discharged and checked at the outpatient office.
Results. Mean follow-up was 22 weeks with a range of 1 to 70 weeks. At postoperative descending venography, the reflux of the superficial femoral vein was significantly improved. At final follow-up, all patients reported greater or lesser relief of subjective symptoms. In four limbs with class 6 disease, ulcers healed and did not recur. In one limb with class 5 disease, ulcers did not recur. In the other 10 limbs with class 4 disease, a distinct clinical improvement occurred with resolution of skin changes. VRT was normal in 11 of the 12 limbs examined.
Conclusions. Our preliminary experience demonstrates that angioscopy-assisted anterior valve sinus plication gives early good clinical and hemodynamic improvement in patients with primary deep venous insufficiency.