The Treatment of Varicose Veins Using the Venous Valve Cuff

Abstract

Objective: To assess the safety and efficacy of venous valve cuffing for the treatment of varicose veins. Design: Three prospective studies were performed. The first study was the subjective and objective evaluation of venous valve cuffing in a series of unselected patients with varicose veins. Indications for use of the technique were defined in the first study, and applied in the second study, which focused on an evaluation of objective outcome criteria. The third study was an evaluation of the long-term effect of venous valve cuffing. Setting: Royal North Shore Public Hospital, Mater Private Hospital and Peninsula Private Hospital (Sydney, Australia). Patients: In the first series there were 93 limbs in 72 unselected patients with varicose veins. The second series consisted of 78 limbs in 62 patients who were selected based on the indications established in the first study. A third series of 100 limbs in 75 patients, selected at random, was reviewed to assess the long-term subjective and objective outcome. Measurements: All clinical outcome variables were observed subjectively. Photoplethysmographic recovery times and reflux at the sapheno-femoral junction (SFJ), at the knee, and below the knee were measured. Vein diameters at the groin and at the knee were measured pre- and postoperatively. Results: Unselected patients have a good clinical outcome, but approximatley one-third have residual venous reflux at the SFJ. Selected patients with mild to moderate varicose veins have an excellent result in all criteria investigated. Conclusions: After competence is restored to the SFJ, the saphenous vein decreases in size and achieves physiological one-way flow. Venous valve cuffing demonstrates a low incidence of symptoms and recurrence in both the short and long term.