ORIGINAL ARTICLES   

Acta Phlebologica 2002 April;3(1):39-48

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: English

Deep intravenous atypical valvuloplasties. Four cases report

Corcos L. ¹, Cavina C. ², Peruzzi G. ², Procacci T. ², Spina T. ², De Anna D. ³

¹ Master in Phlebolymphology, University of San Marino and Ferrara; ² Prosperius Institute for Clinical Research, Firenze; ³ Department of General Surgery, University of Udine

Several ­reports indi­cate the reli­abil­ity of ­deep intra­ve­nous val­vu­lo­plas­ty (IVV) how­ev­er ­none of ­them ­give infor­ma­tion ­about the sur­gi­cal treat­ment for atyp­i­cal mor­pho­log­ic con­di­tions of ­venous ­valves. The ­authors ­described 4 cas­es affect­ed ­with ­deep ­venous insuf­fi­cien­cy (DVI) of the low­er ­limbs due to var­i­ous atyp­i­cal alter­a­tions of ­venous ­valves and the ­role of atyp­i­cal intra­ve­nous val­vu­lo­plas­ties (­AIVV). Four ­patients ­were select­ed by ­duplex, Doppler ­venous pres­sure ­index, pho­to­ple­thys­mog­ra­phy and ascend­ing phle­bog­ra­phy. Case 1: Female of 52 ­years, ­right ­limb: symp­toms ­from pri­mary DVI, ear­ly dis­tro­phy and 3 cm aneu­rysm of the pop­li­teal V. Aneurysm resec­tion and tri­cus­pid ­valve recon­struc­tion (8 ­years fol­low-up.) Case 2: ­female of 48 ­years, ­left ­limb: symp­toms ­from pri­mary DVI and 4.5 cm aneu­rysm of the com­mon femo­ral V con­tain­ing a mono­cus­pid ­valve. Aneurysm resec­tion, mono­cus­pid ­valve recon­struc­tion (7 ­years fol­low-up). Case 3: ­male of 28 ­years, ­left ­limb: symp­toms ­from sec­on­dary DVI, dis­tro­phy, 2 cm ­ulcer; pop­li­teal V insuf­fi­cien­cy ­with one atroph­ic ­cusp. Monocuspid ­valve recon­struc­tion (4 ­year fol­low-up). Case 4: ­male of 45 ­years, ­right ­limb: symp­toms ­from sec­on­dary DVI, dis­tro­phy, ­healed ­ulcer; pop­li­teal V insuf­fi­cien­cy. Tricuspid ­valve recon­struc­tion (3 ­years fol­low-up). All the post­op­er­a­tive con­trols ­were per­formed by non­in­va­sive exam­ina­tions. Clinical improve­ment and val­vu­lar paten­cy ­were ­obtained in all the cas­es; ­reflux elim­i­na­tion in cas­es 1, 2, and reduc­tion in ­case 3, 4; hae­mod­y­nam­ic nor­mal­iza­tion in cas­es 1, 2, 3, ­case 4 ­unchanged; ­stable ­ulcer heal­ing in ­case 3; dis­tro­phies improve­ment in cas­es 2, 3, 4. Deep ­AIVV can be effec­tive­ly per­formed in atyp­i­cal cas­es affect­ed ­with pri­mary and sec­on­dary DVI of the low­er ­limbs.